This chapter examines the politics of trade and investment agreements and how they interact with the politics of health at the global and domestic levels. The chapter first examines the operation of the World Trade Organization (WTO) and its implications for health, illustrating this with a WTO dispute between Indonesia and the United States involving the latter’s ban on flavoured cigarettes. It then examines aspects of the ‘next generation’ of trade and investment agreements that have particular implications for health policy, notably investor-state dispute settlement and regulatory cooperation. The analytical focus of this chapter is on political processes and political actors at the global and domestic levels that interact to produce trade policy and its impacts on health.