The aim of universal immunization is to control congenital rubella syndrome by interrupting transmission of rubella virus among young children through immunization of all children, male and female, on or after their first birthday, thereby decreasing the chances that a susceptible pregnant woman would be exposed to the virus. Concerns about rubella vaccine (durability of protection, safety, and communicability) no longer determine the choice of universal vs. selective immunization. Rather, the cost of vaccine, the accessibility of the target populations, and the vaccine coverage attainable in practice influence the choice of strategy. Either universal or selective immunization should, if properly implemented, eventually control rubella and congenital rubella infection. However, the choice of universal immunization recognizes the difficulty involved in immunizing 100% of the women of childbearing age, and the universal strategy offers the advantage of rapidly reducing congenital rubella infection by interrupting transmission and provides early protection to unvaccinated individuals by reducing their risk of exposure.