Background Non-communicable diseases from unhealthy lifestyles account for most preventable deaths in the UK. Physiotherapy training now includes Health Promotion (HP) for the reduction of unhealthy lifestyles such as obesity, smoking, alcohol and inactivity. However, physiotherapists' perceptions of HP in the context of musculoskeletal care in the UK have not been explored.Objectives To explore musculoskeletal physiotherapists' perceptions of HP. Design Phenomenographic qualitative research Method semi-structured interviews with 7 musculoskeletal physiotherapists. Results/findings Physiotherapist conceptions of HP were analysed using phenomenographic analysis and three main categories emerged. These were the concepts of physiotherapists' self, education in the therapeutic alliance and persons' agency for change. Each category contained a variety of perceptions which were sometimes conflicting, and each category had scope for influencing the others. Conclusions Participants' (physiotherapists) perceptions of their personal and professional self were entwined with perceptions of persons' agency when describing health promotion in their practice. Within the therapeutic alliance concepts of health coaching were discussed but these conceptualisations sometimes contradicted descriptions of experiences. This research may encourage physiotherapists to reflect on their perceptions of, and role in HP.