Early childhood education and care (ECEC) environments are unique settings that offer education and care for children. In this chapter, the author uses ECEC to refer to all types of early childhood settings, including preschool, day or family childcare, long day care, kindergarten or Pre-K (pre-kindergarten) and nursery. Children who attend some ECEC centers can be as young as 6 months of age, up to the age of seven in some countries. The chapter provides an overview of the literature on effective interventions to promote physical activity in ECEC settings. It evaluates components that may contribute to more successful interventions. The chapter addresses some of the key issues, emerging themes and key recommendations pertaining to ECEC-based physical activity interventions. It provides a broad summary of ECEC interventions that focus on physical activity or have a physical activity component. A number of key issues were highlighted as well as emerging trends that need to be considered in future interventions.