Over the past three decades the proportion of students classified as overweight has almost tripled. This trend in childhood obesity is a cause for concern. Stakeholders have come together to stem growth and implement healthy habits in childhood to not only prevent obesity, but also future cardiovascular risk. School-based health interventions have proven to be an effective medium to reach youth. Sustainable practices remain the largest determinant of long-term success of these programs. Project Healthy Schools, a community–university collaborative school-based health intervention program, sustainable practices have led to positive changes in participating middle schools. This collaborative has provided important insight on key factors needed for long-term sustainability for a school-based wellness program. These key factors are described under leadership, policy, finances, and reproducibility. Future school-based programs may plan for success with sustainability while drawing from our experience.