Background: Prevention has been identified as a primary strategy for reducing health care costs, with potential Medicare savings up to $142.8 billion annually. Falls alone resulted in $28.2 billion in direct care costs. A growing body of research documents significant benefits of tai chi (TC) for balance and prevention and management of chronic diseases in older adults. Purpose: To identify facilitators and barriers to TC from a theory-driven approach, using the Health Belief Model (HBM) coupled with a fishbone diagram. Methods: Focus groups consisted of active users of a fitness facility at an active living community. Group 1 had never considered adoption of TC (n = 10). The second group were members of the community TC classes (n = 11). The HBM was used to categorize responses. A 10-point scale permitted comparison of group means and standard deviation. Results: Primary barriers included lack of awareness of benefits, need for evidence-based benefits, and limitations related to teaching style. The largest opportunity for promotion of TC related to perceived threats from falls and benefits for balance. Translation to Health Practice: Findings can be used by health educators to develop and test effective cues to action to promote adoption of TC.