The immunization coverage trends in the Tigray region from 2000 to 2024 reveal significant fluctuations across key vaccines (BCG, DPT3, Measles, and full basic vaccination). Between 2000 and 2019, there was steady improvement in all indicators, with full immunization coverage rising from 43.5% in 2000 to 73% in 2019, reflecting the impact of expanded immunization programs. However, data from Tsadik et al. (2023) show a sharp decline in 2021 across all vaccines—particularly full coverage, which dropped to 20%—likely due to disruptions caused by the conflict and humanitarian crisis. By 2024, there were signs of recovery, with DPT3, measles, and full coverage improving again, though BCG data was unavailable. These patterns underscore both the resilience and vulnerability of health systems in conflict-affected regions.