This review explores the role of school medical services in promoting psycho-physiological well-being among students, emphasizing the importance of physical activity in schools. Schools are ideal settings for health education, especially for primary students, as habits formed here influence lifelong behaviors. The school medical service supports health promotion by integrating physical activity into daily routines, such as during class, breaks, and before/after lessons. Physical activity is crucial for cognitive development, social skills, and emotional well-being. The review highlights the need for a multidisciplinary approach to health promotion, considering the collective well-being of students, families, and communities. Physical literacy and health literacy are key concepts, with physical activity enhancing psycho-physical health. Active breaks during lessons are effective in improving students' well-being, attention, and social skills. The review also discusses the impact of physical activity on reducing sedentary behaviors and obesity, as well as its cognitive and social benefits. In Italy, active breaks have been promoted through guidelines and multi-component projects, aiming to increase physical activity levels in schools. Internationally, similar initiatives are being implemented to combat sedentary lifestyles and promote healthy behaviors in children. The review underscores the importance of integrating physical activity into school curricula and the need for coordinated efforts to ensure its effectiveness.This review explores the role of school medical services in promoting psycho-physiological well-being among students, emphasizing the importance of physical activity in schools. Schools are ideal settings for health education, especially for primary students, as habits formed here influence lifelong behaviors. The school medical service supports health promotion by integrating physical activity into daily routines, such as during class, breaks, and before/after lessons. Physical activity is crucial for cognitive development, social skills, and emotional well-being. The review highlights the need for a multidisciplinary approach to health promotion, considering the collective well-being of students, families, and communities. Physical literacy and health literacy are key concepts, with physical activity enhancing psycho-physical health. Active breaks during lessons are effective in improving students' well-being, attention, and social skills. The review also discusses the impact of physical activity on reducing sedentary behaviors and obesity, as well as its cognitive and social benefits. In Italy, active breaks have been promoted through guidelines and multi-component projects, aiming to increase physical activity levels in schools. Internationally, similar initiatives are being implemented to combat sedentary lifestyles and promote healthy behaviors in children. The review underscores the importance of integrating physical activity into school curricula and the need for coordinated efforts to ensure its effectiveness.