The Universal Immunization Program (UIP) is the cornerstone of India's disease prevention endeavour, aimed at protecting children and pregnant women from Vaccine-Preventable Diseases (VPDs). The Expanded Program on Immunization (EPI) was designed and launched by the World Health Organisation (WHO) in 1974, with BCG, OPV, DPT and Measles Vaccine (MV) in children and Tetanus Toxoid in pregnant women, all given free of cost. India adopted EPI in 1978 without MV. MV was rolled out nationally during 1985-1990 following which EPI was re-named Universal Immunisation Programme (UIP). In 2000 the National Technical Advisory Group on Immunisation (NTAGI) was established and under its recommendations, newer vaccines have been systematically included in UIP. India introduced targeted immunization drives, and digital platforms for vaccine logistics management. This paper reviews UIP's major achievements, discusses emerging concerns, and proposes ways forward to address these gaps.