OBJECTIVES: This study elucidates the status of public health governance, defines the concept and synthesises the evidence to guide stakeholders in enhancing governance for the delivery of essential public health functions (EPHFs). DESIGN: A scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. DATA SOURCES: A systematic search of peer-reviewed literature was performed using PubMed and Embase for English-language publications from 2000 to April 2025, supplemented by a grey literature search. ELIGIBILITY CRITERIA: We included literature addressing public health governance and institutional arrangements. We excluded documents focusing solely on disease-specific and clinical governance, and governance at supranational level. EXTRACTION AND SYNTHESIS: Data from 177 included documents were extracted and analysed to identify definitions, components, actors, enablers and principles relevant to public health governance. Findings were complemented by WHO's experiences to develop an operational definition and framework. RESULTS: Findings revealed the absence of a standardised definition of public health governance and highlighted the diversity of actors within and across health and allied sectors. Findings identified strategy and policy development, oversight, partnership, legal authority, resource stewardship, and monitoring and evaluation as key components of public health governance; legislation, financing, institutional structures and political will as key enablers; and integration, comprehensiveness with equity and shared responsibility as key principles. Four institutional models were identified: autonomous public health bodies, semi-autonomous bodies under health ministries, public health departments within ministries and interministerial platforms without a designated institute. CONCLUSION: Despite differences in institutional structures, successful delivery of the EPHFs depends on clearly defined roles and effective coordination across sectors. Government-led reviews and reforms are needed urgently to strengthen public health governance through institutional clarity, sustained investment and cross-sectoral collaboration for building resilient, trusted and equitable systems.