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Background: To reduce burden of pneumonia, India has introduced Pneumococcal Conjugate vaccine (PCV) in routine immunization programme. The state of West Bengal, India introduced PCV in 2021. Uptake of new vaccines depends a lot on knowledge of caregivers on the disease and vaccine . This study aimed to assess the knowledge of caregivers regarding pneumococcal diseases and PCV. The study will inform programme managers to develop a comprehensive demand generation strategy for improving uptake of PCV and other new vaccines., Methods: It is an observational, cross-sectional study using a predesigned, pretested and structured questionnaire conducted among 353 caregivers of children who has received at least one dose of PCV. The children were aged between 6 weeks to 20 months, residing in rural and urban areas of Howrah district of West Bengal. Sample size was calculated considering 95 % confidence interval and 5 % margin of error., Results: Results are analysed taking into consideration rural/urban divide, socioeconomic status and other factors influencing vaccine uptake. Study findings suggest lack of knowledge of caregivers regarding pneumococcal diseases and PCV. Most of respondents have no idea about any other pneumococcal diseases apart from pneumonia. More than 40 % does not know about what causes pneumonia and more than 47 % does not know how to prevent pneumonia. They also have poor knowledge about injection site, number of doses, schedule and when to start PCV., Conclusions: Limited knowledge among caregivers may cause negative impact on vaccine coverage and jeopardise the goal of government to reduce morbidity and mortality due to pneumonia.The study findings suggest that there is dearth of knowledge regarding pneumococcal diseases and PCV among caregivers. Therefore the policy makers need to develop a comprehensive plan for awareness generation for improving PCV uptake and strategy developed for this purpose can be implemented in future new vaccine introduction also., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)