Research indicates that the main reason why teachers change their practice is the recognition of improvements in students’ educational outcomes (Guskey TR, Teach Teach 8(3):381—391, 2002). To ensure widespread dissemination of health promoting schools, evidence that the health promoting school approach can be a crucial vehicle for enhancing both students’ health- and educational outcomes are therefore warranted. This advocates study designs and methods that take into account the multifaceted, whole-school and context specifi c characteristics of health promoting schools. In this chapter, we therefore fi rst discuss specifi c challenges in health promoting school research, and secondly, we propose an evaluation design combining the advantages of different research methodologies to examine the health promoting school’s effectiveness in creating “better schools through health”. © Springer Science+Business Media Dordrecht 2015