Background: One of the largest impediments of efficient immunization is the wastage of vaccines. Monitoring of vaccine wastage helps to improve vaccine forecasting and minimize wastage. As the costs of vaccination increases, better vaccine management is essential. Methods: Conducted a record based descriptive study and the details of all the vaccine vials issued and details of the children who received vaccines from immunisation clinic were captured from August 31st 2021 to July 31st 2023 by universal sampling technique at tertiary care centre AIIMS, Bibinagar, Hyderabad. Results: A total of 1474 vaccination given to under 5 children and found that vaccine wastage rate of BCG is the highest (80.45%) followed by MR (68.37%), IPV (67.63%) and DPT (64.44%).Lyophilised vaccine has highest wastage rate 74.9% followed by Reuse types (open vial) is 74.9% and least is vaccine with oral route of administration is 45.45%. Conclusion: This study has generated evidence for enhanced policy decisions and generated recommendations that have been helpful in strengthening the immunization supply chain system in a holistic manner.