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: 1) by protecting the health and promoting the wellbeing of students, staff and the wider community through their policies and practices, 2) by increasingly relating health promotion to teaching and research and 3) 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.