Semi-structured interviews with 22 national immunization program managers and advisors across 11 LMICs conducted between May and August 2025 examined stakeholder perspectives on expanding HPV vaccination to older adolescent girls (15–18 years) and young boys (9–14 years). Slightly more stakeholders prioritized older girls, citing continued vaccine effectiveness post-sexual debut, independent health-seeking capacity, and evidence from countries where older-girl campaigns accelerated broader HPV awareness. Vaccinating boys was viewed as equitable and logistically feasible within existing school platforms, but faced barriers including the absence of Gavi subsidies for boys, financial constraints, and limited local epidemiological data on male HPV-related cancers. Both expansion pathways require tailored communication strategies, additional resources, and stronger local evidence to support policy decisions in resource-limited settings.