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Introduction: Vaccination is an effective public health intervention; however, coverage of vaccination is declining in states like Tamil Nadu which have good health indicators. Objective: To evaluate the presence of vaccine hesitancy among parents of children between 1 and 5 years of age attending the paediatric out patient department of a tertiary care hospital in Chennai and to assess its relationship with attitudes towards vaccines. Material & Methods: A cross sectional questionnaire-based survey was conducted among 100 consecutively sampled parents of children between 1 and 5 years of age attending a tertiary care paediatric out-patient department. The Parental Attitude towards Childhood Vaccines scale of vaccine hesitancy and the Beliefs and Attitudes towards Childhood Vaccines scale were used to measure vaccine hesitancy and beliefs and attitudes towards vaccination respectively. The data were analysed descriptively and statistical correlation between vaccination attitudes and vaccination hesitancy were studied. Results: In the predominantly urban, educated, working class population, the prevalence of vaccine hesitancy was 21%. But all the children had received complete vaccination appropriate for age. The major drivers for vaccine hesitancy were suspicions about newer vaccines, concerns about adverse effects of vaccines and the perception that there is no need for vaccines against uncommon diseases. The vaccine hesitancy scores were negatively correlated with the vaccine attitude scores (R = -0.266; p = 0.007). Conclusion: Vaccine hesitancy is present among the sampled mothers and is influenced mainly by concerns regarding safety of newer vaccines. Vaccine hesitancy needs to be clearly addressed for strengthening the Universal Immunization Program.