Uganda hosts one of Africa’s largest refugee populations, yet displaced and migrant communities face persistent barriers to routine immunization. Despite commitments to vaccine equity, many remain unprotected against preventable diseases. This narrative review synthesizes evidence from peer-reviewed studies, national surveys, and institutional reports up to September 2025 to assess immunization coverage, challenges, and potential solutions among refugees and migrants in Uganda. Findings indicate that vaccination rates in refugee communities are generally lower than national averages due to administrative barriers, vaccine shortages, long distances to health facilities, language difficulties, and misinformation, challenges intensified during the COVID-19 pandemic. Economic hardship further limits healthcare access. However, several strategies show promise: integrating refugees into national immunization systems, simplifying registration processes, strengthening mobile outreach, engaging community health workers, and improving cross-border data coordination. Addressing these inequities requires both technical and social commitment, through adequate financing, inclusive policies, and meaningful community engagement. Achieving equitable immunization for refugees in Uganda is essential for public health protection and the realization of universal health coverage.