This study explored the public health advocacy role of staff employed at a major South Australian specialist public hospital that had made an organisational commitment to health promotion. It was concluded that staff did have a role to play in public health advocacy, though the issues pursued primarily related to disease and injury prevention rather than the broader social determinants of health. Staff gained valuable experience in the political processes of public health advocacy. The hospital had to develop organisational infrastructures to support staff so they could undertake public health advocacy on behalf of the hospital. It was also necessary for the hospital to implement other changes in order to ‘get its own house in order’ before issues could be addressed in the broader community.