The majority of Americans remain inactive despite evidence of significant health benefits from even moderately intense activity. Previous intervention efforts have generally focused on changing individual behavior. This article discusses the use of policy, legislative and regulatory, and environmental interventions in promoting physical activity to prevent cardiovascular disease (CVD) and other chronic diseases. The authors present evidence on the need, formulation, description, and effectiveness of policy and environmental intervention approaches. Types of approaches addressed to promote physical activity include federal, state, and local legislation and regulation, policy development and implementation, and environmental support. They also describe opportunities for state and local health departments to initiate and participate in environmental and policy approaches.