Institutions of higher education have long been concerned about promoting health among students. The settings-based approach to health promotion can potentially enhance the contribution of universities to improving the health of populations and to adding value in the following ways: by protecting the health and promoting the well-being of students, staff and the wider community through their policies and practices; by increasingly relating health promotion to teaching and research; and by developing health promotion alliances and outreach into the community. This working document provides conceptual and practical guidance on how to set up and develop a health-promoting university project. It combines a series of innovative case studies from the United Kingdom and the outcome of a WHO round table meeting on the criteria and strategies and operational attributes of the Health Promoting Universities project, and an action framework for a European Network of Health Promoting Universities.