The public health challenges of moving dangerous substances across jurisdictions have led to a renewed international focus on the importance of the health perspective in the Basel Convention on Transboundary Movement of Hazardous Wastes and their Disposal. This paper systematically reviews the health dimensions of the Basel Convention and the ways in which the Convention can be strengthened. It analyses the limits of the health objective of the Convention in promoting public health and the environment and the potential for optimising it. The paper argues that an examination of the Convention's substantive, procedural, and institutional and implementation mechanisms highlights its failure to fully achieve its potential for health protection. Parties to the Convention have initiated measures to address this issue, but the design and functioning of the Convention itself constrain the full achievement of health goals, which in turn undermines the protection of human health and the environment. To optimise the health promotion, the author argues for an adaptive governance framework by bolstering the governance mechanisms of the Convention and the Secretariat, strengthening health cooperation between international health agencies and improving domestic implementation of the Convention by its Member States.