BACKGROUND: This paper reports on research undertaken for the King's Fund inquiry into quality in general practice and examines the health promotion role of the general practitioner. METHODS: Literature review of health promotion in general practice focusing on smoking cessation, childhood immunisation, coronary heart disease (CHD) and obesity. In addition the paper draws on interviews with practice and public health staff. RESULTS: General practitioners (GPs) and their practice teams have a crucial role in promoting health and preventing disease. Consultations provide an ideal opportunity for preventing illness and disease but general practice focuses primarily on secondary prevention. Many GPs state they lack the skills needed to deliver effective health promotion. CONCLUSIONS: Issues, such as GP commissioning, provide a new set of challenges for public health and ill-health prevention. The evidence base is growing but general practice, public health and academics need to work together to improve this.