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Immunization is a critical component of public health, and it undergoes various trends and developments over time. Immunization is considered one of humanity’s most remarkable journeys. It has helped save countless lives and will help save more if the goals of the 2030 Immunization Agenda (IA2030) are achieved. India is home to one of the largest global immunization programs. Immunization trends refer to the patterns and changes in the development of vaccines, the use of vaccines, and vaccination programs within a nation. There have been various trends in vaccine development and immunization in India. Trends can be influenced by various factors, including vaccine coverage, new vaccines, vaccine hesitancy, advances in medical science, technological innovations, public-private partnerships, public health policies, and public awareness. India has the world's largest immunization program regarding the number of vaccinations delivered, the recipients, the geographic spread, and the human resources required. In this review, we give an overview of various trends in immunization in India dating from the ancient era. A search of the PubMed, Scopus, and Google Scholar databases from 1945 to February 2024 was done to conduct a narrative review. This review includes English-language publications. This narrative review was conducted to summarize the government of India’s actions and strategies for immunization and vaccine development and also to trace the trends in immunization in India. It covers various vaccination programs of the Indian government and measures that were made to fight vaccine hesitancy and to enhance vaccination coverage such as developing vaccination roadmaps, scheduling vaccinations, utilizing digital health technology, monitoring vaccinations, and developing creative techniques. India has the world's largest Universal Immunization Program, vaccinating around 29 million pregnant women and 26.5 million infants annually. These trends reflect India’s ongoing commitment to immunization as a component of public health policy and efforts to address existing and emerging health challenges.