Sri Lanka’s HPV vaccine introduction process began with extensive evidence generation in 2009, including studies on HPV prevalence, genotype distribution, and cervical cancer burden. Cost analyses evaluated screening and treatment expenses, vaccination strategies (age, campaign vs. routine, school vs. community), and program feasibility. After initial rejection in 2010 due to high vaccine costs, a 2015 review led to policy approval by the national advisory committee. Preparations included cold chain assessments, advocacy campaigns addressing gender-specific vaccination concerns, and collaboration with education and health sectors. The program launched in 2017 using a school-based approach targeting Grade 6 girls (10–11 years) with a two-dose quadrivalent schedule, achieving high coverage from inception.