In this study the implementation of cooperation directed learning of peer tutoring in elementary general inclusive physical education (GPE) setting in three elementary city schools in Sweden was studied. The purpose was to assess the impact of peer tutoring on the interaction behaviours between students with and without disabilities in GPE. A design of multiple case study with elementary school age students with moderate disabilities (n = 4) was used. Peer tutors (n = 37) were students without disabilities who voluntary participated in a peer tutor training programme. The programme included the collaborative learning values, teaching instructions and communication skills served as the independent measure. Dependent measures were multiple interactions between students with and without disabilities. Data to the case studies were collected through a design of mixed methods, containing both quantitative and qualitative data. Totally 43 observation sessions of inclusive GPE settings were collected on videotapes and analysed using the Computerized Evaluation Protocol of Interactions in Physical Education (CEPI-PE). In addition, interviews with school personnel and children served as a complementary study outcome. The percentage of interactions between target students and peer tutors significantly increased (3.2-11.8%, respectively, p < 0.05) during peer tutor intervention. This study indicated that peer tutor arrangements can contribute the successful cooperation between students with and without disabilities in inclusive GPE in Swedish elementary school. All four students with moderate disabilities maintained high percentage of activities done independently throughout baseline and intervention phase (50.5 and 57.6%, accordingly). Qualitative data throughout field notes and interviews with school personnel and pupils confirmed a positive class climate change and improvement in peer relation culture.