Policymakers should focus on reducing risk factors and ensuring equitable access to preventive and therapeutic care for NCDs. This study aimed to identify health promotion challenges and opportunities for NCDs in Iran. This qualitative study involved semistructured interviews with 14 participants, including policymakers and experts in obesity, diabetes, hypertension, and cardiovascular disease management in Iran. Interviews were conducted via Skype, recorded, and transcribed. A deductive approach was applied to extract codes using MAXQDA 10 through open coding. Qualitative analysis identified five main categories and 14 subcategories of challenges and opportunities for addressing NCDs in Iran, aligned with the Ottawa Charter for Health Promotion; policy levers for NCD prevention, including legislation and economic growth creating health-promoting environments, focusing on strengthening physical and social infrastructure community and Individual empowerment for health, focusing on social capital development, public participation, improving the quality of education, and promoting health literacy and transforming Healthcare for better health, organizing health systems and eliminating conflicting interests. The critical important of policies, environmental determinants, community involvement, and healthcare frameworks was highlighted. A holistic approach is essential for the effective prevention and management of NCDs.