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Background Since its introduction in 2008, Scotland’s Human papillomavirus (HPV) vaccination programme has undergone major revisions, including expansion to adolescent boys in 2019 and shifting to a single-dose schedule in 2023. However, persistent uptake inequalities remain.Methods A retrospective policy evaluation was conducted to assess equity in programme delivery from 2019 to 2024. Secondary data from Scottish and UK Government sources, peer-reviewed literature, and reputable reports were used within 10 years of 2025. The evaluation was conducted using the CDC Programme Evaluation Framework (2024), a Logic Model, and the PROGRESS-Plus framework.Results Persistent gender disparities were identified, with adolescent boys consistently demonstrating lower vaccine uptake, suggesting gaps in gender-specific knowledge and engagement. Socioeconomic inequalities also widened, reaching a 12.7% uptake gap between the most and least affluent groups in 2023/24. This pattern appears linked to school absenteeism, the non-statutory Relationships, Sexual Health and Parenthood (RSHP) education, and limited catch-up opportunities following the transition to a single-dose schedule. Geographic variation was minimal overall but remained evident in remote small towns, where logistical barriers likely contributed to reduced access. Nevertheless, catch-up campaigns in these areas helped restore uptake to national levels. While both the Scottish and UK Governments acknowledged the equity risks associated with the dosage change and introduced targeted interventions, current evidence remains insufficient to determine their overall impact.Conclusion Gender and socioeconomic disparities continue to constrain equitable HPV vaccine delivery in Scotland. Strengthening male-focused education, standardising RSHP curriculum delivery, and reinforcing catch-up mechanisms are crucial to narrowing persistent gaps. Government-led initiatives have been key facilitators of progress. However, sustained stakeholder collaboration and future evaluation will be essential to ensure long-term equity in programme delivery.