Purpose: This study aims to explore school health promotion (HP) as a set of institutionally embedded professional practices. Design/methodology/approach: This is a qualitative study using data from nineteen interviews with school professionals in Sweden. Data analysis was informed by practice theory and an institutional logic perspective. Findings: School professionals constructed practical understandings of HP at the intersection between institutional directives and professional values. Professionals were challenged by multiple and occasionally ambiguous policy directives as well as by multiple tiers of governance. Professional understandings of institutional directives were mediated by a bureaucratic logic and three instantiations of a professional logic (competence, pragmatic and entrepreneurial). School leadership was perceived as a crucial link between institutional directives and professional practices. Practical implications: The findings draw attention to the need for policy revision and disambiguation as well as the need for establishing dynamic institutional dialogues across levels of governance. These measures can foster sage leadership and fruitful interprofessional collaboration within school HP. Originality/value: The findings provide a multi-perspective view of school HP and link professional values to institutional ones. The study sheds light on the explanatory relevance of human cognition in practice contexts.