Physical education, originally called physical culture, began as hygiene and physiology instruction taught by the college's resident physician. From these humble beginnings, physical instruction eventually expanded into the gymnasium, a room in the Main Building. Plans and funding for a new gymnasium were crushed in 1900 after a typhoid fever epidemic. A mandatory walking period and intermural athletics continued for many years without formal curriculum. The outdoor facilities for sports were confined to four tennis courts and a small athletic field. With the development of the student Athletic Association in 1900, sports gained a large presence on the campus and a quarter of the student body was participating in the organization within two years. The fairly new sport, basketball, was soon the game of choice, followed closely by tennis. In 1907, a new gymnasium was established in South Spencer Dormitory and a professional director was also chosen.

The name physical training replaced physical culture and the term physical education was officially adopted in 1917. Hygiene and personal health were at the focus of the physical education program. For incoming students, a postural examination had long been required. This test was joined in 1907 by other physical education requirements: a mandatory course focused on calisthenics and gymnastics; an all-black uniform of long-sleeved blouse, tie, long bloomers, and stockings. Despite the new emphasis on physical education, the legislation continued to refuse calls for a real gymnasium housed in its own building. Hockey and baseball soon joined tennis and basketball as sports at the college. Class teams, annual field days, camping, and hiking were extremely popular in the 1910s.

In 1919, the student government president Adelaide Van Noppen convinced the college to try a one-year experiment with intercollegiate athletics. Fay Davenport, the physical education director, opposed this action on the grounds that intercollegiate competition physically harmed and exploited women. A prevailing idea of the time was that females should practice moderation and be limited to less strenuous intermural competition. Intramural athletics continued to be popular in the 1920s, and they were often substituted for the recreation period, formerly known as the walking period. During this conflict over the fate of intercollegiate athletics, the physical education program underwent several changes in management.

The 1920 arrival of Mary Channing Coleman marked a shift in the program's direction. Coleman, originally hired as Davenport's assistant, was promoted to director in 1921. It was during this same time that the federal government began to fund public health education. By the time of her death in 1947, Coleman had molded the physical education department into a leading training program of female physical education teachers. This program was the first of its kind in North Carolina. Flourishing under the prosperity of the 1920s, the physical education program expanded into new facilities. The old Spencer gym was replaced in 1922 by a fifty by ninety-foot outdoor gymnasium. Three years later, in 1925, the Rosenthal Gymnasium was constructed with a basketball court and swimming pool. The former dairy farm gave way to space for playing fields and tennis courts near the gymnasium. With these new buildings, the curriculum thrived as well. Coleman diligently picked physical education majors who were not just interested in sports, but also academically successful.

This strategy proved effective for the physical education program. While Coleman improved the program, she clung adamantly to the idea that intercollegiate sports were harmful for women. Nevertheless, mixed-team competitions with players from multiple institutions gained popularity.

Following the sudden death of Coleman in 1947, Ethel L. Martus succeeded her as the new director and continued the legacy of Coleman. By 1940, twenty-nine activity courses were offered. The program advanced beyond just training future teachers; as graduates pursued careers in dance, recreation, and corrective work, the curriculum adapted to meet new needs. Eventually, in the 1940s, the first graduate work in physical education was offered in dance. The program expanded its graduate offerings in the 1950s; the 1949 MFA degree in dance was followed by the 1951 master of education in PE and 1959 master of science. In 1966, a doctor of education in physical education was officially established. These new graduate degrees enhanced the image of the physical education program. Built and opened in 1952 the opening of a second gymnasium, named for Mary Channing Coleman, provided the facilities for advanced physical education courses.

The health department reunited with physical education and recreation in 1963. The new department contained four divisions: health education, physical education, dance, and recreation. Intramural and intercollegiate athletics, financed by student fees, served as non-academic divisions. Coeducation dramatically impacted the department as separate facilities and faculty members were desired for male students. While male faculty members were hired, requests for a separate gymnasium were denied. Physical education gained school status in 1971, and by 1978, activity courses actually counted as academic credit. The college also dropped the two-course requirement in physical education. The program officially offered a Ph.D. in physical education in 1987. This new doctoral degree replaced the previous Ed. D.

In 1991, HPERD became the School of Health and Human Performance. Then, in 2011, the School of Health and Human Performance merged with the School of Human Environment Sciences to form the School of Health and Human Sciences. Dr. Celia Hooper, who was dean of HHP, became the interim and then permanent dean of the new school at its formation.