Primary vaccination at birth is a vital precaution to ensure the early protection of children against diseases and death. There is a regional variation of birth vaccination in Nigeria, which is against the SDG goals channelled towards achieving universal health coverage and eradicating communicable and non-communicable diseases. This study examined Nigeria's regional disparity and determinants of zero-dose vaccination at birth. The study used a child-recode dataset from the Nigeria Demographic and Health Survey (NDHS, 2018). A sample of 4,634 children of women of reproductive age was considered the sample size. The outcome variable is zero-dose vaccination based on when a child does not receive a dose of HBV, OPV and BCG at birth. Frequency count, percentage and chi-square were used to analyse the data. The result showed that the northeast and northwest had the highest prevalence of zero-dose vaccination for children at birth (80.4% and 78.4%, respectively). The individual and community-based interventions needed to eliminate low birth vaccination should consider the place of delivery, number of antenatal visits, religion, education, household decision making and exposure to mass media.