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Widespread implementation of Exercise Is Medicine® on Campus (EIM-OC) has the potential to address college student physical inactivity; however, limited research has comprehensively assessed how EIM-OC is operationalized at campuses.This study aimed to assess EIM-OC implementation and outcomes at various academic institutions.A survey was developed in consultation with key EIM-OC stakeholders and administered online among EIM-OC representatives. Data collected included institutional information; promotion, education, and healthcare system integration; partnerships; challenges; and goals. Descriptive statistics were used to explore institution characteristics and other variables. Thematic analysis was conducted to identify the dominant themes and subthemes in qualitative data collected from open-ended questions.Forty-one responses were received from a diverse group of academic institutions ranging in size (<10,000 to >50,000 students) and type (public and private). Campus recreation departments, campus health providers, and student organizations/clubs emerged as the most important partners. Student involvement was critical to the success of many EIM-OC programs, with students involved in a range of roles from promotion (n = 20), leadership/organization/planning (n = 18), education (n = 16), implementation (n = 14), and data collection (n = 10). Implementing the physical activity vital sign emerged as a common challenge, with many institutions having no protocol in place for arranging a follow-up between students and physical fitness professionals after referral acceptances, and no protocol existing for referral declinations. Finally, social media was underused, with no social media platforms used by over a third of programs.EIM-OC programs at various institutions experienced similar challenges. This research will serve to inform and improve on the implementation and outcomes of EIM-OC programs and ultimately contribute to helping academic institutions increase the physical activity of students and their local communities.