Background <p>Reliable electricity is essential for healthcare delivery, yet underserved facilities in Low- and Middle-income countries (LMICs) often face energy deficits and frequent power outages. The rural Primary Health Centers (PHCs) serve as the first point of care for the underserved population in India. These facilities often struggle to deliver effective health services due to unreliable energy supply. The present study explored the multi-stakeholder’s perspectives on the impact of solar electrification of PHCs on improved health outcomes, effective service delivery and resilient healthcare infrastructure in Rural Karnataka, India.</p> Methods <p>We conducted a qualitative phenomenological study across five districts of North Karnataka, India. A total of 29 in-depth interviews were conducted among various stakeholders including frontline healthcare providers such as medical officers, nurses, technicians, Accredited Social Health Activist (ASHA), and other support staff, along with local communities. Interviews were recorded, transcribed, translated into English and thematically analyzed, adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines in reporting the present study.</p> Results <p>Two main themes emerged: (1) Energy reliability and critical care management with positive impacts on maternal and child health outcomes and service resilience during pandemic and disasters; and (2) Operational efficiency and cost savings including reliable vaccine storage, reduced electricity bills and improved data management systems through solarization of PHCs.</p> Conclusion <p>The perspective highlighted notable changes with the pre and post solarization of PHCs, strengthening the quality, reliability and resilience. It enabled safer deliveries, continuous vaccine cold chain management and improved emergency responses. Scaling the solar powered health infrastructure offers a sustainable pathway to advance universal health coverage and resilience in underserved regions.</p>