This European framework for quality standards in school health services and competences for school health professionals, developed by the WHO Regional Office for Europe, aims to support the 53 Member States of the WHO European Region to develop and sustain school health services as part of their national health systems. The framework, which is focused primarily at national- and regional-level policy-makers responsible for school health service standards and service quality, can be adapted by individual countries to enable them to develop services that reflect health priorities and health systems. The national standards should support managers and experts to develop and maintain quality services that meet children and adolescents’ health needs and support institutions that train school health service professionals in developing specific curricula. Instead of recommending a specific way of organizing school health services, mandating a single process for dividing work among health professionals or creating a definitive set of quantitative standards, the framework allows individual countries to tailor it to their own specific needs.