In health promotion, enthusiasm for sustainability has frequently overshadowed critical reflection with regard to whether this aim is warranted, let alone feasible. Consequently, the not insubstantial body of literature on sustainability in health promotion is not particularly helpful to decision makers. In this paper we seek to provide some guidance for the development of sustainability for health promotion interventions, arguing that it is necessary to be able to differentiate between (i). levels of social organization which are the focus of change, (ii). the programmes and agencies which are the means employed to achieve change, and (iii). the outcomes or effects that are achieved. Furthermore, funding allocations need to be congruent with programme characteristics if one is serious about achieving sustainability.