Experts agree that physical activity is critical to children's health and development. Child care is an ideal setting that could be used to increase physical activity given the large number of young children enrolled. To effectively address physical activity at child care, it is necessary to understand what strategies are most effective. This article reviews existing intervention studies targeting physical activity conducted within a child care setting (including preschools, nursery schools, and day care). Given the limited work in this setting, liberal criteria were used that allowed for inclusion of studies with diverse outcomes (physical activity, physical activity-related, motor skills) and a variety of research designs (randomized control, quasi-experimental, single group). Searching six databases, 1355 studies were located, and 19 met inclusion criteria. Half of the studies that assessed intervention impact on physical activity reported significant findings. All five studies measuring motor skills and eight assessing physical activity-related outcomes demonstrated generally positive findings. Although the variety of outcome measures and research quality made it difficult to draw conclusions, findings do provide encouragement that regularly provided, structured physical activity programs can increase the amount and intensity of physical activity that children receive and improve children's motor skills. These studies also demonstrate that the organized child care setting provides multiple targets for intervention beyond structured activity programs; however, additional studies are needed to explore such opportunities.