In 1974, the World Health Organization (WHO) established the Expanded Programme on Immunization (EPI) to ensure all children had access to routinely recommended vaccines. Initially, those vaccines were limited to bacille Calmette-Guérin vaccine (BCG), diphtheria-tetanus-pertussis vaccine (DTP), oral poliovirus vaccine, and measles-containing vaccine (MCV). Global coverage with the third dose of DTP (DTP3) increased from <5% in 1974 to 79% by 2005. However, one fifth of the world's children, especially those in low-income countries, still were not fully vaccinated during the first year of life with the four traditional EPI vaccines. In 2005, WHO and the United Nations Children's Fund (UNICEF) developed the Global Immunization Vision and Strategy (GIVS) to improve national immunization programs and decrease vaccine-preventable disease-associated morbidity and mortality. A goal was to reach a sustained national DTP3 coverage of 90% in all countries. This report summarizes global routine vaccination coverage during 2011. An estimated 83% of infants worldwide received at least 3 doses of DTP in 2011, similar to coverage in 2009 (82%) and 2010 (85%). Among 194 WHO member states, 130 (67%) achieved ≥ 90% national DTP3 coverage. More than half of all incompletely vaccinated children (i.e., those who did not receive DTP3) lived in one of three countries: India (32%), Nigeria (14%), and Indonesia (7%). Strengthening routine immunization services, especially in countries with the greatest number of undervaccinated children, should be a global priority to help achieve the fourth Millennium Development Goal of reducing mortality among children aged <5 years by two thirds from 1990 to 2015.