Infrastructure for active travel (AT) is receiving attention as a low-cost, sustainable transport option that promotes physical activity. However, the planning and implementation of new AT infrastructure often brings challenges. This review synthesises stakeholders’ views and experiences of developing guidance for, designing, commissioning and implementing environmental interventions to promote AT. Eight databases were searched for studies containing qualitative data from stakeholders with direct experience. Results were synthesised thematically. The risk of bias was assessed using the CASP checklist for qualitative research, and evidence quality using the GRADE-CERQual tool. A total of 21,703 articles were identified from database searches, with 35 studies included. Eighteen studies focused on infrastructure promoting walking and cycling, fourteen on cycling and three on walking. Fifteen studies were judged to have no/very minor concerns, 12 had minor concerns, four had moderate concerns and four were of serious concern. A variety of stakeholders were influential, most commonly supportive elected leaders and individuals in public and voluntary sectors. Inter-disciplinary collaboration facilitated sharing of expertise and resources, and upskilling was beneficial. Effective communication methods varied between stakeholders and reason for communication. Persuasive strategies included aligning with stakeholders priorities and making the best use of evidence. Opportune moments to implement AT infrastructure were alongside non-AT projects and exogenous events. Compliance with AT policies could increase by embedding in higher level legislation. Political support was important and fostered through not de-prioritising cars and gaining external funding. The GRADE-CERQual found high confidence in our findings, apart from the sub-themes “Methods of communication” and “Political will” that had moderate confidence. Our findings can assist stakeholders in successfully navigating the process from conception to implementation of AT infrastructure and inform future policy and decision-making.