Abstract Seasonal influenza continues to impose a significant health and economic burden on low- and lower-middle-income countries (LLMICs), where vaccine uptake remains critically low. Despite proven benefits of vaccination, the implementation of successful influenza vaccination strategies in these regions is hindered by a complex interplay of multiple barriers, including limited resources, evidence gaps, infrastructural challenges, and socio-cultural factors. Although lessons from high-income countries offer valuable insights, their direct application in resource-constrained settings without contextual adaptation is often ineffective. Exploring the underlying barriers and developing successful interventions tailored to the unique realities of LLMICs is critical, as influenza poses a threat for the next potential pandemic. Multifaceted strategies incorporating culturally informed and risk group–specific interventions, including healthcare provider engagement for vaccine recommendations, promoting local research, leveraging existing platforms, strengthening surveillance systems, and fostering international and domestic support, can facilitate inclusive evidence-based policymaking.