This thesis explores school health promotion (HP) as a set of policy discourses and professional practices embedded in the institutional context of the Swedish school. It is a compilation thesis comprising three studies. Study 1, a critical policy analysis, explores how HP is articulated in education policies and how this articulation acknowledges the social and democratic dimensions of HP. Study 2 explores how school professionals conceptualize their roles and responsibilities in relation to the increased use of social media among students and how this conceptualization is related to institutional affordances and constraints. Study 3 investigates how school professionals navigate the institutional landscape in schools in the course of their HP work. The thesis draws attention to the links between HP practices and institutional development and provides some suggestions as to how institutional variables can be manipulated to sustain and improve these practices.