<p>Vaccination is a crucial public health intervention that reduces both morbidity and mortality globally. This study aims to assess and compare the vaccination coverage rates for routine childhood immunizations across different Lebanese governorates between 2011 and 2018. This is a retrospective secondary analysis. It incorporates vaccination data of 67,000 children (aged 0–18 years) documented by the “Health Society”, a prominent non-governmental organization, during its ‘Immunization’ project that aimed to improve childhood immunization in Lebanon. The project was carried out under three successive phases: Household Survey and Referral phase (2011–2014), Mobile Vaccination Clinics phase (2015), and Integrated Referral and Mobile Vaccination phase (2016–2018). Vaccination coverage rates for routine childhood immunizations were calculated for each governorate. Comparative analyses using SPSS V26 were performed to identify variations in vaccination rates across different governorates. Vaccination coverage rates demonstrated significant variability across Lebanese governorates and throughout the study period. In 2011, the average vaccination coverage was 51.2%. By 2018, coverage had dropped sharply to 13.1%. Mount Lebanon recorded the highest coverage during the study period, reaching 57%. In contrast, the South governorate showed a steady decline in coverage from 64.1% in 2011 to 10.5% in 2017. By the time coverage in the South reached 12.6% in the final year, the governorate had already experienced several years of very low coverage. These results highlight concerning trends in vaccination coverage, particularly in the South governorate, emphasizing the need for targeted interventions. This study highlights disparities in childhood vaccination coverage across Lebanese governorates. These findings underscore the need for targeted interventions and public health strategies that improve vaccination rates and ensure equitable access to immunization services.</p>