Background: Maternal and Child Health (MCH) programs play a crucial role in improving immunization coverage, particularly in underserved rural and urban areas. Immunization is a vital public health intervention that reduces the burden of vaccine-preventable diseases. However, disparities exist in vaccination coverage due to socio-economic factors, healthcare accessibility, and awareness levels. This study aims to evaluate the impact of MCH programs on immunization rates in both rural and urban settings.Materials and Methods: A cross-sectional study was conducted over six months across selected rural and urban healthcare centers. A total of 600 children aged 0–5 years were included, with 300 from rural areas and 300 from urban areas. Data were collected using structured questionnaires and immunization records. Statistical analysis was performed using SPSS, with chi-square tests and logistic regression used to determine associations between MCH program interventions and immunization rates.Results: The study found that overall immunization coverage was significantly higher in urban areas (85%) compared to rural areas (72%). The availability of healthcare facilities, awareness programs, and transportation accessibility were key factors influencing vaccination rates. Children in urban regions had greater access to healthcare services, while rural areas faced challenges such as vaccine hesitancy, limited healthcare resources, and long travel distances. MCH programs that included home visits and community awareness sessions showed a 15% improvement in vaccination rates in rural areas.Conclusion: MCH programs have a significant positive impact on immunization coverage, particularly in rural settings where access to healthcare is limited. Strengthening outreach services, increasing awareness, and improving healthcare infrastructure can bridge the gap between rural and urban immunization rates. Policies focusing on equitable healthcare distribution are essential to ensure comprehensive immunization coverage.