The Healthy School (or Health-Promoting School as a term used by WHO and other countries) is a whole-school approach to promoting health in a school setting. Healthy Schools and Health-Promoting Schools frameworks extend around the globe are important strategies that provide opportunities to improve the health of children and adolescents and to tackle health inequalities in the population. Two decades since the Healthy Schools framework was advocated in Saudi Arabia. This paper sets out to review relevant literature and reports related to Healthy Schools in Saudi Arabia. Very few studies have been conducted to assess the Health Schools framework. The findings showed that there is a gap between the ideal concepts of the Healthy Schools framework and current implementation. Promoting healthy diet and physical activity as a starting point for wider implementation. Providing financial resources and ongoing capacity-building opportunities for the teachers and associated school staff. Collaboration between the health and education sectors is required to provide a prolonged framework for monitoring and evaluating the healthy schools outcomes.