School has been identified as a suitable arena for health promotion and teachers are highlighted as crucial for student health. In Sweden, where the study is set, teachers are tasked with school health promotion in national legislative and policy documents. However, research shows that student health can be perceived as situated outside the teacher professional identity and Swedish teachers are traditionally not educated in health. This paper presents findings from a qualitative study conducted in two Swedish high schools. The aim is to examine the students’ perspective of the role of the teacher in working with student health. Interviews with 34 students aged 16–19 years were carried out. Data were analysed using qualitative content analysis with theoretical underpinnings from pragmatism and symbolic interactionism. This approach identified four dominating roles for teachers: 1) a creator of joyful learning, 2) a creator of a sense of control, 3) a spreader of happiness, and 4) a creator of feeling valued. This study shows that the role of the teacher in working with student health is in acting, not in being, and that this role is constantly (re)created through interaction. The student perspective of the role of the teacher in working with student health has close similarities to the role of the teacher in inclusive teaching, merging relational competence with didactic skill. In conclusion, we argue that developing teachers’ didactic as well as relational competency, along with understanding competence within a pragmatic and symbolic interactionist theoretical framework, could improve student health practices.