Physical activity is essential to preventing obesity and promoting mental health among children and adolescents; yet, obesity prevalence and physical activity indicators for these groups have either deteriorated or shown little improvement in recent years. In order to promote physical activity at schools, recent policy initiatives have sought to both enhance the quality of and allocate more hours to physical education (PE), and encourage school sports club activities. However, hindered by various constraints―such as shortages in workforce and material resources both within and beyond school settings, poor coordination across programs, a lack of strategies to make physical activity programs appealing to children and adolescents, and restrictions driven by concerns over potential complaints―these policy measures have often been administered in a perfunctory manner and remained limited in effect. Further promotion of school-based physical activity requires veering away from a PE-centric model toward an integrated approach to making physical settings conducive to physical activity, strengthening staffing support, developing strategies that motivate students, and linking various programs within the framework of the current Physical Activity Promotion System.