Skeletal muscle is a highly adaptable tissue, responding significantly to well-designed resistance training (RT) programmes with the aid of nutrition. While research on skeletal muscle hypertrophy is a vast area, this chapter aims to provide a comprehensive overview of how to support the growth and maintenance of this tissue from a health-based performance perspective. The chapter starts by delivering an overview of factors that determine skeletal muscle hypertrophy, as well as the drivers and mechanisms that produce hypertrophic adaptations to help understand and support the adaptability of this tissue. A comprehensive discussion around energy and protein needs for skeletal muscle hypertrophy is provided, while recognising that integrative body health is also vital to support an athlete’s anabolic/catabolic balance. In this context, consideration is given to contemporary theories of the gut-muscle axis, and how it applies within a sporting context. In addition, the concept of the athlete’s ecosystem will be introduced, and brought to life with a case study that showcases integrative thinking.