Immunizations have extensively contributed to worldwide reductions in morbidity and mortality by diminishing the occurrence of serious infectious diseases. Today, people everywhere in the world experience the advantages of immunizations. The present study was aimed to determine the knowledge, awareness, and practices regarding the immunization schedule among the rural and urban population in Salem district, Tamilnadu. A community-based cross-sectional study was conducted between November 2018 – April 2019 among 250 children from a rural area and 250 children from urban areas up to 16 years of age. 88% of children were found to be fully vaccinated in the urban area whereas 81% of children were found to be fully vaccinated in the rural area. 41% of parents were found to be aware of immunization on the other hand only 30% of parents in the rural area were found to be aware. The main reason for non-immunization was found to be a lack of knowledge. Immunization coverage in the urban slums of Salem district is still way short of the 85% coverage mark. A lack of information and motivation among the parents is the main reason for this dismal scenario, that needs to be rectified at the earliest. © 2020 Elsevier B.V., All rights reserved.