Efficient supply chain management in the health sector is essential for the continuous availability of essential medicines, medical supplies and other health commodities. Yet many low-resource countries still rely on fragmented or paper-based Logistics Management Information Systems (LMIS). In Lesotho, this fragmentation reduces data visibility, data accuracy and timely decision-making. This paper presents a case study on localising the OpenLMIS platform to address these challenges. It outlines the system’s design process, contextual adaptations, and results from a pilot implementation across ten health facilities. Key innovations include customised workflows, a Point-of-Delivery microservice, improved stock visibility and alignment with national standard operating procedures. Pilot findings indicated improved data availability and positive user acceptance. The results highlight the importance of localisation, modular architecture, and capacity building for sustainable digital health systems.