Cardiovascular diseases (CVDs) and their risk factors are increasing with associated disability and mortality burden globally, especially in low- and middle-income countries, including Cameroon. Physiotherapist-led health promotion (PLHP) interventions provide opportunities to improve health and reduce this burden. Understanding physiotherapists' practice, confidence, and perception is crucial for designing effective, context-specific PLHP interventions. This qualitative study explored physiotherapists' practice, perceptions, and confidence in delivering PLHP to pwCVDs in Cameroon. Sixteen participants completed the interviews, and analyses of the transcripts generated three main themes, which included (1) the perception of physiotherapists' roles in health promotion (HP), (2) current practice of PLHP, and (3) competence in the delivery of PLHP. Physiotherapists believe that delivering HP interventions in practice is within their professional role. Current HP practice was limited to exercise, physical activity, and dietary/nutritional interventions. Participants reported a lack of knowledge and formal training in PLHP delivery. Despite intense interest in HP, HP practice among physiotherapists is limited in scope, is under-resourced, and is limited by a lack of confidence in delivering behavioural change interventions. These findings are relevant for the design of appropriate clinical training and policies for the care of pwCVDs.