The paper addresses the issue of student participation from the perspective of the health-promoting schools initiative. It draws on experience from the Macedonian Network of Health-Promoting Schools and its collaboration with the Danish as well as other country networks within the European Network of Health-Promoting Schools. Student participation is viewed as one of the main focal points of the conceptual framework and model of a health-promoting school developed within the Macedonian context. This model and the model distinguishing between two different qualities of participation--genuine and token participation--are presented and discussed in the paper. Underpinning values that these models endorse as important for the processes of health promotion in schools include self-determination, participation, democracy, diversity and equity. (Contains 1 note, 1 table, and 1 figure.)