Physical education debuted in higher education in 1860 at Amherst College. The program, aimed at the general student body, thrived under the leadership of Edward Hitchcock, Jr., M.D. Similar programs were developed elsewhere. At its high point, an estimated 97% of colleges and universities required their students to partake in some form of physical education in order to earn a bachelor's degree. The early physical education pioneers were trained as medical doctors responsible for all aspects of student hygiene. Physical education ultimately evolved into its own academic discipline, known today as kinesiology. As the discipline codified, physical education programs aimed at addressing the needs of the total student body became increasingly marginalized. Regardless, quality college and university instructional physical activity programs (C/UIPAP) continue to this day and they have enormous unrealized potential for addressing student, institutional, and societal needs. Recommendations for helping C/UIPAP thrive in the 21st century are advanced.