During March 2018–May 2019, an outbreak of 4,115 measles cases occurred in Israel, following international importations, mainly from Ukraine. Approximately one half of the cases (2,202) occurred in residents of Jerusalem District, primarily in unvaccinated children in orthodox Jewish communities. The district’s population (1.25 million, approximately 14% of the national population) is 70% Jewish, approximately one third of whom are orthodox Jews. Children in those orthodox communities have lower rates of routine vaccination coverage; for measles vaccine, first dose coverge is 78.4%, compared with 90.1% among children in all other communities. Measles outbreak control in communities with long-standing inadequate vaccination coverage is challenging (1). Urgent response measures led to containment of this outbreak; however, sustaining vaccination coverage will require targeted interventions and resources.