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<b>Background:</b> Physical activity can help prevent and manage diseases, mental health conditions, and improve social connectedness and quality of life. However, integrating physical activity into long-term care settings remains a structural challenge. This paper presents a comprehensive overview of the systematic development and synthesis of a national, multidisciplinary guideline for integrating physical activity into routine long-term care practice. <b>Methods</b>: A multidisciplinary working group (<i>n</i> = 13) developed the guideline. A national online questionnaire (April-May 2023), disseminated through 20 organisations, identified and prioritised key challenges for implementing physical activity in long-term care. Next, critical questions were formulated and answered by systematic literature reviews, complemented with input from a focus group and sounding board groups, including all stakeholders. Recommendations were drafted and finalised through structured consensus procedures, integrating scientific evidence, stakeholder perspectives, contextual considerations, and professional expertise. <b>Results</b>: The guideline addressed the following critical questions: Why is physical activity important? How can care organisations best organise physical activity-focused care? How can care and support professionals integrate physical activity into the daily lives of clients? How and which physical activities can best be applied to stimulate physical activity? How can technology help? How can clients and their informal caregivers be motivated to engage in physical activity? Concrete recommendations were provided and remaining knowledge gaps identified. <b>Conclusions</b>: This guideline represents an important step towards embedding physical activity as a fundamental component of long-term care. It offers practical and evidence-informed recommendations for incorporating physical activity in routine long-term care practices, specifically addressing the unique challenges encountered in long-term care settings. The knowledge gaps can guide research to further support practice to normalise physical activity in long-term care.