Regardless of age, sex, race, ethnicity, socioeconomic status (SES), education level, or geographic region, obesity rates have increased considerably and one key factor is the lack of daily physical activity (PA) for children. Therefore, it is necessary for schools to implement PA options outside of the regular physical education (PE) curriculum, such as after-school programs focusing on health and wellness. After-school programs were originally designed to increase overall health and PA and/or reduce weight in student populations (Wilson et al., 2008). Now, it is more common to focus on healthy eating and lifelong PA. The purpose of this study was to examine elementary girls' perspectives of an after-school health and PA program. Data were collected at four program sites during one school year, including interviews and observations with 16 female elementary participants. Three themes emerged: 1) supportive environment, 2) student practice, and 3) more choice in activities. Although this afterschool program did not provide an autonomous environment, it is suggested autonomy would enhance participation if participants had choice, freedom, and ownership over curriculum and activity ideas. However, developing positive social environments were an important factor in students' engagement in these programs.