Health education in New Zealand schools has a chequered history, peppered with controversy since its inclusion as a school subject in the early nineteenth century. In this paper we examine the trials and challenges faced by health education teachers over time, pointing to the particular components of this subject that are regarded as controversial and analysing the obstacles to its successful implementation. We briefly map the changing nature of health education across time, before discussing contemporary aims and purposes of health education. We suggest health education seeks to enable and equip children and young people with the knowledge, skills and motivation to make health enhancing choices for themselves and for others. To conclude, we explore future directions for health education, proposing several health competencies as viable options for a 21st century world.