Historically, physical education (PE) has been designed to do one thing--teach sport skills. However, it is now being asked to deal with lifestyle issues such as obesity and inactivity. Since the target and purposes of PE have changed, a fundamental shift in the way it is delivered is essential to its survival. This article highlights some difficult realities that PE professionals must face and provides specific, long-term recommendations for the development of PE in the 21st century. It is intended to stimulate discussion and solution seeking.