The last decades have seen a marked increase in the number of immunocompromised patients. These patients are at higher risk for severe outcomes from infections, many of which are vaccine-preventable diseases. However, such complex cases raise several important issues of concern: 1. The administration of live vaccines to an immunocompromised patient may lead to adverse events and exacerbate the underlying condition? 2. Vaccines should preferably be administered prior to the planned immunosuppressive therapies. 3. Vaccination with inactivated vaccines may not ensure complete immune responses and may lead to lower and shorter protection rates depending on the extent of immunosuppression. 4. Should household contacts of immunocompromised patients receive vaccines? Which vaccines can be safely administered to household members? 5. Do clinicians have sufficient or updated information concerning the safety, efficacy and contraindications to vaccination of such at-risk patients? 6. Which vaccines can be safely administered to immunocompromised travelers to tropical destinations? The answers to those questions are multifaceted, and data on safety, immunogenicity, and efficacy of vaccines for immunocompromised populations are limited. This article summarizes the current recommendations for immunizations in immunocompromised patients, indications and potential adverse effects.