Expanded program on immunization (EPI) was launched in Ethiopia in 1980 to achieve universalrnchild immunization by 1990. Children of under-one year of age and women of reproductive agerngroup (15-49 years age) are the targets for the EPI vaccines. In spite of the improvement inrnimmunization coverage over the past many years, achieving this goal becomes difficult to thernpresent time. Therefore quality assessment is important to determine whether the primary healthrncare Service is provided according to the established norms. Although the immunization coveragernhas increased, the quality of the immunization programme is still questionable.rnObjectivernThe main aim of this study was to assess the structural, process and outcome quality dimensionsrnof Routine EPI program in terms of client satisfaction in under five children.rnMethodologyrnThis study was descriptive cross-sectional health facility based survey using quantitative method.rnData collection for this evaluative research was conducted from March 10/2014-April 11/2014 atrnfive public health facilities found in Debre Markos town. To determine the sample size; 95%rnconfidence interval, 5% margin of error (E) and non-response rate equal to 5% has been used.rnUsing the formula the total sample size calculated for the exit interview was 392 respondents.rnThe study has been conducted on four health centers and one hospital of the town that deliver EPIrnservice. The data collection has been carried out from March 10/2014-April 11/2014.rnResultrnIn this study two health centers reported as there was no adequate BCG vaccine, almost allrnfacilities reported as there was inadequate financial allocation and 60% of facilities reported asrnthere was deficit in means of transportation and mean score for parents who were told aboutrnpossible side effects and importance of immunization were (20.2%) and (44.39) respectively rnPositive findings obtained in this study were for the case of telling the appointment for the nextrnvisit (mean score 98%), availability of cold chain monitoring chart, monitoring temperaturerntwice/day including weekend and maintaining normal storage temperature (100%), human powerrnaspect 100% of the EPI coordinators of facilities had above one year working experience, meanrnscore of clients who got all vaccines they were supposed to take that day was 95.5% and 100%rnavailability of functional refrigerators. The mean scores of structure, process and clientsâ€™rnsatisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively.rnConclusionrnOverall, the quality of the service was found to be under category three of EVM parameter, butrnstill there existed some areas which needed more attention, such as staffsâ€™ in-service training,rntransportation and financial allocation to run the service properly and addressing proper EPIrneducation and counseling to mothers. The health workers and program coordinators failed to keeprnup their standards in these works.rnPositive findings obtained in this study were for the case of telling the appointment for the nextrnvisit (mean score 98%), availability of cold chain monitoring chart, monitoring temperaturerntwice/day including weekend and maintaining normal storage temperature (100%), human powerrnaspect 100% of the EPI coordinators of facilities had above one year working experience, meanrnscore of clients who got all vaccines they were supposed to take that day was 95.5% and 100%rnavailability of functional refrigerators. The mean scores of structure, process and clientsâ€™rnsatisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively.rnConclusionrnOverall, the quality of the service was found to be under category three of EVM parameter, butrnstill there existed some areas which needed more attention, such as staffsâ€™ in-service training,rntransportation and financial allocation to run the service properly and addressing proper EPIrneducation and counseling to mothers. The health workers and program coordinators failed to keeprnup their standards in these works.