Background: The worldwide growth of non-communicable diseases requires important lifestyle adaptations. The earlier a healthy lifestyle is adopted, the better. Enabling a healthy lifestyle for children during the preschool years ideally involves the cooperation of parents and teachers. Health promotion with parents and teachers is most effective if it takes into consideration their views and opinions, as well as context. Objective: The aim of this study was to explore perceptions of health and healthy lifestyle from the perspective of preschool children's parents, and the staff caring for children attending preschools in three diverse settings. Design: Qualitative in-depth study. Setting: Preschools in Western Cape Province, South Africa. Method: Data were collected through six focus group discussions and analysed using qualitative content analysis. Results: Parents and staff shared a holistic view of health, agreeing that children and their health were primarily the responsibility of the parents. Informants described their own health and that of children as affected by a variety of interconnected factors, including environmental, economic, social and individual influences. Conclusion: When tailoring a health-promoting education programme, it is important to consider the pre-existing knowledge the participants have and the context in which intervention will take place. There is also a need to structurally address social determinants of health that may be beyond the control of the individuals.