Background: Public health models have been used to address a number of school-based concerns, notably in the identification and treatment of students at-risk for academic or behavioral deficits. Significant benefits are associated with this model as, compared to a traditional approach, the focus is shifted from remediation to prevention, and from student pathology to student strengths. Methods: Although this model has been applied to multiple populations and used across a variety of settings, it has yet to be conceptualized as a framework for the integration of school-based physical activity (PA). Results: This article first reviews the public health service delivery model as well as the benefits of PA on children's physical health, mental health, and cognitive outcomes. Second, suggestions for incorporating PA into the schools using a 3-tiered system and as barriers to success are discussed. Conclusion: School-based PA is a promising tool--and yet an overlooked and undervalued intervention--for a number of concerns applicable to children's academic achievement and overall mental health. (Contains 1 table.)