Through examples of small and medium-sized towns in East Africa mountain areas, in Uganda and Tanzania, the paper focuses on the changing role of secondary towns through their commercial functions, acting as nodes in wide trade networks (fieldwork conducted in urban and rural markets of the studied areas). The local productive systems have turned to market gardening to face the drastic decline of cash crops like coffee and new products and productions are now inundating local markets, like fruits and vegetables but also imported Chinese or secondhand clothes, shoes or kitchenware. Trade connections are more open and complex than before with strong processes of spatial and economic differentiation and specialisation. The position of secondary towns is at the same time challenged by new roads, new (often external) actors and new strategies, with visible bypassing effects (direct connections between rural and large cities), but also remains inconspicuously important for servicing rural areas. The paper presents the changing role of these secondary towns in globalisation, then stakeholder interplays (old and new, local and exogenous) in these new configurations, finally the redistribution of markets localisation, as an adaptation to new opportunities and challenges in globalised trading systems.