Introduction : Rashtriya Bal Swasthya Karyakram (RBSK) program in Tamil Nadu has significantly advanced child health services by focusing on early identification and management of health conditions. Launched to address the “4Ds” – Defects at Birth, Developmental Delays, Diseases, and Deficiencies – in children from birth to 18 years, RBSK has made notable strides in improving child survival and reducing morbidity. Tamil Nadu has pioneered several innovations within the RBSK framework, including the integration of real-time GPS monitoring for vehicle tracking, digital screening through the Tamil Nadu Education Management Information System (TN EMIS) app, and Newborn Screening or Delivery Point Screening to detect birth defects early. These innovations have streamlined the screening process, ensured accountability, and enhanced follow-up care through effective data management and interdepartmental collaborations. By maintaining transparency through Advanced Tour Programme (ATP) updates and addressing challenges through strategic initiatives, the state has ensured that health services reach even the most remote areas. With the continuous innovation in child health services, Tamil Nadu’s RBSK program has set a high standard for public health initiatives. This paper highlights the significant innovations introduced in Tamil Nadu's RBSK program and discusses their effect on improving early detection, intervention, and long-term child health outcomes.