We conducted a national study examining how COVID-19 vaccination services can be effectively integrated into Liberia’s routine immunization system. The assignment assessed policy alignment, service delivery capacity, cold-chain readiness, community acceptance, and operational challenges across multiple counties. Using mixed methods (KIIs, facility assessments, data review, and stakeholder consultations), the study identified integration gaps, system strengths, and practical opportunities for harmonizing workflows. The findings informed evidence-based recommendations to strengthen routine immunization performance, improve vaccine uptake, and enhance long-term health system resilience.