In this systematic review, we present results of how teachers can create better conditions for students, with or without disabilities affecting social interaction, who meet challenges with social interactions. We aim to answer the research question: How can teaching physical education be designed so that students who experience difficulties with social interaction are provided with good conditions for participation, development, and learning? Quantitative and qualitative studies published between 2000 and 2019 were included in the search. Of 8079 studies, 11 studies fulfilled the Swedish Institute for Educational Research and the National Agency’s relevance and quality assessment checklist. The studies included interviews, observations, interventions, or surveys. The students were from first year in primary school up to last year in high school. The results were divided into three themes of importance for improving the learning environment in physical education 1) the importance of trusting relationships, 2) providing structure and support 3) creating a positive learning climate. The first theme describes the importance of relationships. Student experienced that teachers who acknowledge all students' experiences and were attentive to their opinions could strengthen the relationships. When the solidarity between students in the classroom was strong, students felt they were part of the group, which contributed to the learning environment. The second theme describes the importance of providing structure in the form of good and clear planning, explanations, and varied opportunities for students to perform a task. Students requested increased predictability of the lesson provided them with a feeling of control. The third theme emphasises the importance of increasing students’ self-efficacy e.g., students experiences of competence and their belief in their ability for a more stimulating learning environment. The results indicates that creating an atmosphere that is not too performance oriented is eligible. When physical education becomes a learning opportunity rather than a measurement, it contribute to increased participation. A specific teaching method, autonomy-supported teaching, was emphasized in some of the studies to have social-relational benefits. This type of teaching includes attentive listening, taking students’ perspective, creating opportunities to give feedback on teaching and providing enough time to complete different tasks. Ensuring a learning environment for all students in physical education, regardless of ability, experience, and knowledge, is not a responsibility for teachers alone, it concerns and involves all levels in the school organization. The management, principals, legal guardians, teachers, and students need to work together.