Building a competent health promotion workforce with the necessary knowledge and skills to develop, implement and evaluate health promotion policies and practice is fundamental to mainstreaming and sustaining health promotion action. This paper reviews the international literature on competencies in health promotion, examines the competencies developed to date, identifies the methods used in their development and considers what can be learned from the experience of others when establishing international core competencies. The paper considers the advantages and disadvantages of employing a competency approach and the extent to which the competencies identified to date can enhance the quality of practice and update the skill set required to work within changing social, cultural and political contexts.