A national transport, health and environment action plan (NTHEAP) is a key tool and mechanism for developing sustainable and healthy transport in a country. NTHEAPs provide a comprehensive and intersectoral way of planning and implementing transport, environment and health action at the national level. They also call for working across sectors, and action can result in reducing health inequalities, thus contributing to Health 2020, the European policy for health and well-being; the Parma Declaration on Environment and Health; and the action plan for implementation of the European Strategy for the Prevention and Control of Noncommunicable Diseases 2012–2016. This manual was developed to guide NTHEAP development at the country level. It proposes four phases: planning, development, implementation and evaluation. It does not provide specifics on how to establish the general policies or strategies on sustainable and healthy transport, an activity that usually precedes the development of action plans. The manual provides practical advice for each of the phases and steps and highlights good practices from the European Region.