Motivational interviewing (MI) is a technique that encourages behavioral change by exploring an individual’s motivations. Initially developed for mental health, MI is now widely used in primary care, including addressing vaccine hesitancy (VH)—a reluctance to vaccinate despite availability. VH poses a major barrier to achieving high vaccination rates, leading to adverse individual and societal health outcomes. Traditional persuasion methods often fail to address underlying concerns, making MI a valuable alternative. By exploring patients’ reasons for VH in a non-judgmental way, MI fosters meaningful dialogue and change. This chapter outlines MI’s theoretical foundations, core principles, and stages of change. It provides a framework for understanding and applying MI skills, emphasizing the importance of tailoring communication to the varying degrees of VH. Recognizing that VH exists on a continuum, healthcare providers can use MI to meet patients where they are and address their specific concerns effectively. The chapter also explores MI’s practical applications in vaccine discussions, offering strategies to enhance provider–patient communication and improve vaccine uptake. Ultimately, this chapter serves as a guide for clinicians seeking to refine their MI skills and navigate vaccine-related conversations with greater empathy and effectiveness.