Physical activity (PA) participation levels among youth remain well below national recommendations. Thus, a variety of strategies to promote youth PA have been advocated, including multifaceted, school-based approaches. One identified as having great potential is a comprehensive school physical activity program (CSPAP). The goal of a CSPAP is to develop a school culture conducive to promoting lifelong PA across five integral components, each serving as a plausible point of intervention: (a) physical education, (b) PA during school, (c) PA before and after school, (d) staff involvement, and (e) family/community involvement. The purpose of this article is to provide an up-to-date review on all CSPAP components, propose the potential of such comprehensive interventions in increasing youth PA levels, and provide future directions for CSPAP research.