Introduction: Despite the concerted efforts of the central and state governments and other immunization stakeholders, full immunization rates in India remains low. This paper outlines the findings of a comprehensive review of the Universal Immunization Programme (UIP) and provide recommendations to formulate an action plan for improving routine immunization coverage. Design: A mixed-method approach was adopted to collect data under four thematic areas, namely programme implementation, vaccine logistics and cold chain, data recording and reporting system, and programme communication in five high priority states. Results obtained for indicators under each thematic area, were then divided into four categories: a) ≥90 % - good, b) 70–90%-fair, c) 50–70 % - average and d)