Background: Universal Immunization Programme aims at completing the primary immunization (Bacillus Chalmette–Guérin (BCG), Diphtheria, Pertussis (whooping cough) and Tetanus (DPT)3, Oral polio vaccine (OPV)3, and Measles) for all the children in the country by the time Children become one year old. Despite all the efforts put by governmental as well as non-governmental institutes for 100% immunization coverage, there are still pockets of low coverage areas existing. Socioeconomic Status (SES) is an important determinant of the standard of living and health status as it influences the incidence and prevalence of various health conditions. Objectives: Aim of the study was to undertake a comparative study of factors associated with Childhood immunisation at a Village and an urban slum in Pune amongst children of preschool age group. The study intended to compare the factors associated with Childhood immunisation at rural and urban areas in children of preschool age group and to find out reasons for non compliance and drop outs of immunisation, if any. Material and Methods: The study was a cross-sectional analytical study. All children in preschool age group (0-60 months) in these areas were included in the study. The mothers/ reliable informants in the family were individually interviewed, using a pre-tested structured questionnaire. A child was categorized as fully immunised, non-immunised, partially immunised and Immunised for Age. Results and Conclusion: Coverage of vaccines under UIP at urban and rural communities showed a marked variation. While BCG coverage was 87.7% and 79.8% in the two areas, OPV Zero coverage was 88.7% and 80.8%. Similarly, variation was noted in the coverage of the three doses of OPV/DPT. OPV-1 coverage was 85.8% and 72.4%, DPT-1 coverage was 92.2 % and 71.3 %, OPV-2 coverage was 79.9% and 78.5%, DPT-2 coverage was 80% and 69.4%, OPV-3 coverage was 66.4 % and 61.5 %, DPT-3 coverage was 64.3% and 60 % in urban and rural communities respectively. Measles coverage at urban and rural community was 72.5 % and 64.4 %. In both urban and rural communities there was a significant association between Immunisation coverage and mothers education. In both the communities, the main reason observed was ignorance 35.4% and 45.3% respectively at rural and urban community. Other common reasons include casual attitude of the parents (18.5% in urban area) and sick child (13% in rural area). Socioeconomic status had a great impact on the immunization coverage in the study. The need of the hour is an equitable, participatory and intersectional approach to health and health care. Provision of vaccination should not be treated as the sole responsibility of the health sector. Convergence, De-centralisation, Community participation and Social inclusion is the need of the hour. Intensive Health education should be undertaken to enhance respondents’ knowledge about the complete UIP program and to minimize the gaps regarding the knowledge about correct age of administration, doses, place of vaccination. Evidence-based approach to social mobilisation; develop and provide locally sensitive and appropriate and field-tested IEC resources. Focused efforts to strengthen routine immunization programme especially in the underprivileged groups and areas such as slum in cities so that target of universal coverage can be achieved as envisaged at national level.