Background and Objective: The "Health Promoting University" initiative is still unknown in Bulgaria. There is no higher education institution with a strategy for health promotion with clear goals and objectives, officially embracing the principles of health promotion and implementing the initiative. The aim of the present study is to clarify the available conditions and scope of health promotion activities in a concrete Bulgarian university, applying an established tool for self-assessment of health promoting universities. Methods: The study was conducted in three phases at a medical university setting. The Self-Review Tool, a resource of the Healthy Universities network, was culturally adapted to the Bulgarian linguistic and cultural context, in the first phase. The opinion of students, academic and administrative staff on selected statements applicable to the target groups, was sought in the second phase. In the third stage representatives of the academic leadership and the students Council reached a consensus with a Delphi method on how to complete the self-review tool on behalf of the university community, after familiarization with the “voice” of the respondents from the second phase. Results In total 673 respondents took part, representing 10% of all groups: 570 students, 77 academic staff, 21 employees, three members of Student Council and two university leaders. According to the final assessment, the university performed excellent in most of the criteria, except: stakeholder engagement (73%), food (73%) and corporate engagement with the health promotion principles (67%). Conclusions: The university has demonstrated capacity and real health promotion action, without the presence of an officially accepted policy at the institutional level and without the label "Health Promoting University". Strategy, policy, leadership involvement are important factors but their absence is not an insuperable obstacle for health promotion action.