Rapid modernization in Oman has resulted in a massive population shift to the cities, urban sprawl, and a car-depend-ent culture associated with lowered levels of physical activity and elevated rates of noncommunicable diseases. Since the built environment is a major contributing factor to physical inactivity in the Region, this policy brief identifies key steps for creating an urban environment more supportive of physical activity. Such transformations would also have wide-ranging health, social and economic benefits. Design standards appropriate for the local terrain and social–cultural context should be developed using existing neighbourhoods that provide environmental support for physical activity (residential density, mixed land use and street connectivity) and a participatory approach to urban planning. When policy-makers recognize the links between physical activity, urban planning and design, and transportation modalities, a national vision for promoting physical activity can be created and endorsed at the highest levels, thereby providing a government mandate for multisectoral action.