Staple crop yield, quality and sustainable production are critical for domestic food security in developing countries. In Tajikistan, both seed-borne diseases and protein quality impair the yield and the quality of the major staple crop, wheat. Here, we used a detailed two-year survey of fields on 21 wheat-producing farms in Tajikistan, combined with lab analyses on seed health and protein quality, to investigate the presence of seed-borne diseases and bread-making quality in Tajik wheat. Seed samples were collected for the analysis of: (i) the presence of common bunt (Tilletia spp.) using the centrifuge wash test, (ii) the major pathogenic fungi on/in the seed using the agar plate test and (iii) the protein amount and size distribution using size-exclusion high-performance liquid chromatography (SE-HPLC). Field occurrence of common bunt and loose smut was generally low (3 farms in year one (14%) showed common bunt occurrence), but the presence of fungi was observed microscopically on most seed samples (on seeds from 19 out of 21 farms = 91%). Tilletia laevis was the dominant agent in common bunt (present in 19 farms compared to T. tritici present in 6 farms). Altogether, 18 different fungi were identified from seed samples by microscopy. Protein composition, measured with high-performance liquid chromatography as protein amount and size distribution (known to correlate with bread-making quality), differed significantly between samples from different farms and years, although the farm type and land elevation of the farm were not the determinants of the protein composition. The presence of certain fungi on the seed correlated significantly with the protein quality and could then have an impact on the bread-making quality of the Tajik wheat. The presence of seed-borne diseases, a low protein content and weak gluten were the characteristics of the majority of the grain samples, mostly irrespective of farm type and farmer’s knowledge. For sustainable development of the Tajik farming systems, and to strengthen the food security of the country, the knowledge of Tajik farmers needs to be increased independently of farm type; in general, plant breeding is required and certified seeds need to be made available throughout the country.