Patient-held records have been advocated as a means of increasing knowledge of an compliance with the processes of health care. The association between one type of patient-held record, the immunization record, and completion of the recommended immunizations for the first year is examined. Immunization completion rates varied by socioeconomic and medical care use variables; but, for all variables studied, completion rates were higher for those infants for whom immunization records were available than those without such records. An experimental assessment of the usefulness of patient-held immunization records as a means of improving compliance and meeting national goals for levels of immunization is suggested.