Book excerpt: A health-promoting school (HPS) approach was introduced over 25 years ago and has been promoted globally since; however, the aspiration of a fully embedded, sustainable HPS system has not yet been achieved, and very few countries have implemented and sustained the approach at scale. This publication is based on an extensive review of global evidence on the barriers to and enablers of implementation, maintenance and scaling-up of the health-promoting school approach. Its aim is to guide adaptation and implementation of the global standards for HPS. National and subnational stakeholders in all sectors involved in identifying, planning, funding, implementing, monitoring and evaluating the HPS approach will find this publication useful for understanding: what should be done, how it should be done and who should be involved in making every school a health-promoting school.