The purpose of this review is to understand how different college and university physical activity education policies affect college and university students. Given the different policy arrangements of college and university physical activity education programs in the American higher education system, it is important to understand how these different physical activity education policies (i.e., required to earn a baccalaureate degree vs. not required to earn a baccalaureate degree) influence students’ physical activity behavior and motivation. Specifically, the study reviewed the characteristics of physical activity education policies in terms of two different perspectives (i.e., public health perspective vs. a motivational perspective). Having a required physical activity education course policy generally enhanced student accessibility to physical activity education courses and helped to form students’ positive physical activity behaviors during the college and university years and post-graduation, whereas having an elective physical activity course policy was most respectful of student autonomy. Future research may need to explore different influences of physical activity course satisfaction during a semester between the two different policies.