The Intensified Mission Indradhanush 5.0 (IMI 5.0) aimed to extend routine immunization services across India, with a focus on children up to 5 years old. Key objectives included boosting measles and rubella vaccination coverage. By September 30, 2023, over 34.6 million children and 6.5 million pregnant women had received vaccine doses nationally. The Surveillance Medical Officer (SMO) from WHO designated external monitors to oversee session sites and perform house-to-house monitoring. Monitoring took place from October 12-14, 2023, in three health blocks of Cuddalore District. Activities included observing two session sites per day (six total) and surveying 40 households per day (120 total). Separate checklists were provided for session site monitoring and house-to-house monitoring, as per WHO guidelines. All session sites adhered to the scheduled times and locations, with proper logistics. However, some lacked IEC materials for public awareness. House-to-house monitoring confirmed full vaccination coverage for under-five children, with no missed vaccinations identified. Recommendations were made to ANMs to have IEC material to enhance community participation. Monitoring of IMI 5.0 in Cuddalore District demonstrated strong adherence to guidelines and effective vaccination session implementation. House-to-house monitoring confirmed appropriate vaccination of under-five children, indicating successful outreach. Overall, this experience provided valuable insights into operational challenges and opportunities for improvement in future immunization campaigns.