The South African health system is on the brink of major reforms which will include among other things the introduction of the National Health Insurance and the re-engineered primary health care (PHC) strategy. With respect to the latter, school health services is recognized as one the major pillars of the re-engineered PHC strategy. However, school health services in South Africa has historically been faced with challenges that include lack of resources as well as lack of coordination to effectively provide adequate and equitable school health services across the country. The 2003 South African School Health policy was developed to address some of these problems. This study evaluated how this policy was implemented in selected schools in the Cape Town metropolitan area. Overall the policy was implemented according to the implementation guidelines and it was gradually meeting the policy objectives. This policy was also re-launched in 2011. The most commendable aspect in this re-launch was the apparent cooperation between the national Department of Health and the national Department of Basic Education.