Background: Physical education (PE) can be considered the centrepiece of school physical literacy (PL) programs, but ineffective lessons or an absence of PE across the public primary school system has raised concern. This study aimed to evaluate the implementation, acceptability and impact of teacher delivery of PE as part of a multicomponent Physical Education Physical Literacy (PEPL) approach, designed to improve classroom teachers’ provision of PE and PL opportunities within a cluster of suburban primary schools. Method: Within a pragmatic randomised cluster-based trial with mixed methods, a PEPL coach was appointed to seven schools for one school year, with another seven schools continuing their usual practice as the control group. The coach’s role was to support and professionally develop classroom teachers to teach PE and to create opportunities that develop PL inside and outside the school environment. Focusing on Grade 5 teachers, the implementation, acceptability and teacher impact were assessed using direct observations of PE teaching style, a daily log kept by the coach and interviews with principals and teachers. Results: The PEPL coach visited each school on average once a week for the 33 available weeks of the school year. There were several positive effects for teachers and schools. With no classroom teacher initially taking PE or classroom physical activity breaks, all seven teachers regularly introduced a PE lesson and activity breaks into their weekly schedule. PE class instructional time increased (intervention; +4.8 vs. control; −3.5 min/lesson; β = 1.69; SE = 0.76; p =.05), with lessons of greater duration (intervention; +8.6 vs. control +1.9 min/lesson; β = 1.14, SE = 0.58, p =.05) and moderate and vigorous physical activity increased 5.7 min in intervention classes (p <.05). The PEPL coach introduced regular physical activities before and after school and linked the schools with a national sports coaching scheme. Interviews indicated that the PEPL approach was both valued and well-accepted by staff, that classroom teacher confidence to teach PE increased and that principals perceived a shift toward a school ‘culture’ of physical activity. Conclusions: Well-received by classroom teachers and principals, the PEPL approach resulted in classroom teachers introducing both PE and activity breaks into their weekly teaching program and schools were linked to external sport coaching programs. These effects suggest that the PEPL approach enhanced opportunities for the development of physical literacy in this suburban primary school setting. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12615000066583.