The immunization Programme was started in India in 1978 with the objective of reducing the mortality due to vaccine preventable diseases. Immunization coverage levels in infants and pregnant women have increased substantially over the last decade. Immunization coverage levels of 69 to 82% with various vaccines were reported in 1989-90. There is however, a wide disparity in the coverage levels in states and in the districts. While the priority to remains to increase immunization coverage levels, surveillance of vaccine preventable diseases is receiving high priority to identify weak pockets for intensification of immunization services and to document impact. Besides completeness of reporting., emphasis of the surveillance system in many areas has shifted to obtaining information on cases as early as possible to allow epidemiological investigations and effective follow-up action. The achievements in a large number of districts show that the goal of universal immunization, while difficult and challenging, is attainable.