This paper seeks to critically discuss the current state of health promotion, arguing that ambiguity remains in its conceptual foundation, practice and education, which is contributing to its decline in several parts of the world. Drawing on relevant literature, the paper re-examines the status of health promotion as a specialist discipline in its own right and suggests that the reaffirmation of this status can move health promotion from the margins to the mainstream of public health policy and practice. The paper briefly rehearses some common conceptualisations of health promotion before suggesting four tensions which, if resolved, could offer greater conceptual clarity and galvanise the contribution of the discipline in addressing individual and community health across the globe.