Salutogenesis is a theory of health and disease that emphasises the promotion of beneficial measures besides the prevention of risk factors and counteracting pathogens. This paper reframes salutogenesis by situating it within the account of biological autonomy and adaptivity, drawing on recent developments in organisational accounts of living systems. By doing so, the paper provides new insights into the relational, situated and continuous nature of health, and it introduces the importance of supportive ‘salutogenic environments’ to foster adaptivity as the individual and collective capacity to change ourselves, including our environments, to promote health.