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Objectives: The authors aimed to assess the characteristics and integration of immunization services into the prenatal care provided by maternity care units (MCUs) in Italy. Methods: A cross‐sectional nationwide study using a web‐based survey was conducted from June to August 2021. The study population consisted of 342 obstetricians/gynecologists (OB/GYNs), members of the Italian Society of Gynecology and Obstetrics, and heads of MCUs. The main outcome was to assess the performance of several vaccine‐related services among the surveyed MCUs. Results: Overall, 112 of 342 MCUs completed the survey, for an overall response rate of 32.7%. Almost all MCUs (96.4%) provided vaccine information, but only 22% had an onsite vaccination clinic. Less than half (43.8%) offered vaccines during prenatal visits and 75% of those sites required women to set up an extra appointment for vaccination. Although 68% MCUs recorded vaccines administered, only 20% of them managed to record vaccines in their own medical records. The institutional‐logistic issues were the most voted vaccination barrier (40.2%). Conclusions: Institutional barriers and lack of certain vaccine‐related services offered during prenatal care in Italian MCUs might be responsible for many missed vaccination opportunities. Embedding maternal immunization programs within the current prenatal care services might optimize vaccine coverage. Synopsis: The lack of integration between maternal immunization programs and prenatal care services might represent a significant barrier that prevents maternal care providers from recommending and offering vaccines to pregnant women. [ABSTRACT FROM AUTHOR]