This in-depth report examines the South African school health service, and considers its design and intentions against international models. Across countries of all income levels, the dual role of school health in contributing to both the health and education status of children has been recognised. The paper provides an overview of school health services and the integrated school health policy (ISHP) in particular: its evolution and current implementation progress. The review emphasises need for close collaboration between health and education, regardless of which department leads. It also highlights challenges with modes of delivery, resource constraints, and inter- and intra-sectoral relationships