The relationship between the school environment and student health behaviors is increasingly pertinent amidst rising health concerns among youths. This qualitative study, conducted across diverse socioeconomic backgrounds in Vietnam, explores the multifaceted influences of school settings on the health behaviors of students. Data were collected through semi-structured interviews and focus group discussions involving students, teachers, parents, and administrators from three schools, each representing urban, suburban, and rural settings. The study identified key factors within schools' physical and social environments that significantly impact health behaviors. These include the availability and condition of physical facilities, the nutritional quality of food offered, peer influences, teacher engagement in health education, and the availability of mental health resources. Socioeconomic factors and cultural attitudes towards health and education also emerged as significant determinants. The findings suggest that improvements in physical resources, enhanced teacher training in health education, standardized healthy food offerings, and greater availability of mental health services are critical for fostering healthier behaviors among students. This study underscores the need for holistic policy interventions tailored to diverse educational settings to promote overall student health.