We reviewed published and unpublished studies that presented the findings of an economic valuation of an aspect of transport infrastructure or policy, and included data on walking and/or cycling and health effects in the valuation. We included 16 papers, of which three were classified as ‘high; six as ‘moderate’ and seven as ‘low’ quality. There is a wide variation in the approaches taken for including the health effects of physical activity in economic analyses of transport projects. This is not helped by a lack of transparency of methods in many studies. A more standardised approach is called for, including a clearer description of the applied methods and assumptions taken.