The United Nations (UN) mandate of achieving healthful living for all by the year 2015 through the Millennium Development Goals (MDGs) is facing several challenges. In the school environment, and particularly in less developed countries (LDCs), the situation is further strained by both relatively weak infrastructure and competing governmental commitment. Although MDGs offer a holistic approach to remedying many identified problems in the larger society, the authors believe that addressing environmental health issues at schools could help achieve MDGs in many communities worldwide. In this article, the authors comment on fundamental issues in school settings and their environment programs potentially related to attaining MDGs. Their present perspectives cover experiences over the last decade in Nigeria, representing an example from LDCs, and throughout the United States, representing an example from the industrialized countries. The authors suggest that achieving MDGs may be expedited if government agencies and other stakeholders commit to providing basic infrastructure and amenities within and around schools.