Population non-communicable disease (NCD) risk is among the highest in the world in the Pacific region. Increasing physical activity (PA) levels may be effective in reducing NCD risk in the developing and culturally diverse Pacific region. To describe the current practice in promoting PA in the Pacific, program information was sourced from NCD representatives from 19 countries during the Pacific NCD Forum (2009). Additional online searches were undertaken; health officials from 22 countries and NCD key informants from the Secretariat of the Pacific Community and from the World Health Organization were contacted. Eighty-four PA initiatives were identified in 20 Pacific Island countries: 26 took place in the workplace setting, 17 occurred in the school setting, 37 in the community setting and 4 in a clinical or health sector setting. Seventeen programs reached 100-500 individuals, 9 programs reached 500-1000 participants, 13 programs reached over 1000 participants and 3 programs targeted the whole population. The majority (51 of 84) of the programs commenced since 2006. There is a notable increase in the development of PA programs in multiple settings across the Pacific. Lead agencies are often the Ministry of Health offices with leadership support from high-level government positions.