Background <p>Immunization is one of the most cost-effective public health interventions, however, its utilization remains suboptimal worldwide. While pharmacist led vaccination services are well established in high income countries, their implementation in resource-constrained and conflict-affected settings remains insufficiently explored. In Palestine, pharmacists are not currently authorized to administer vaccines, highlighting a critical gap in expanding access to immunization services.</p> Objectives <p>To assess community pharmacists’ readiness and willingness to provide vaccination services in Palestine, and to identify system-level, educational, and regulatory barriers affecting implementation.</p> Methods <p>A cross-sectional survey was conducted among community pharmacists in the West Bank, Palestine. Data were collected between January and March 2024 using a convenience sampling approach. Participants were recruited through electronic and in-person recruitment. A structured self-administered questionnaire adapted from previously published instruments, modified for the Palestinian context, and administered in Arabic was used to assess sociodemographic characteristics, willingness to administer vaccines, immunization knowledge, perceived barriers, and professional attitudes. Descriptive statistics and multivariable regression analyses were performed to identify predictors of willingness to administer vaccines.</p> Results <p>A total of 398 pharmacists participated in the study. Only 36.7% expressed willingness to administer vaccines independently, however, willingness increased to 86.9% when appropriate training and legislative support were assumed. Previous immunization experience and gender were significantly associated with willingness (<i>p</i> &lt; 0.05). Key barriers included liability concerns, inadequate training and infrastructural limitations such as storage capacity and administration space. Importantly, most identified barriers were system-related rather than due to lack of professional acceptance.</p> Conclusion <p>Palestinian pharmacists demonstrate strong potential to contribute to immunization services; however, implementation is constrained primarily by structural and regulatory barriers rather than individual reluctance. Addressing legal frameworks, training gaps, and infrastructure limitations is essential to enable pharmacist-led vaccination services. These findings provide context-specific insights relevant to other low-resource or conflict-affected healthcare systems.</p> Clinical trial number <p>Not applicable.</p>