This biennial publication frames the most pressing challenges currently facing colleges and universities--those that demand the board's strategic oversight, vision, and accountability to govern with confidence. The coronavirus pandemic has had profound effects on the operational and financial health of colleges and universities over the previous two years, and that stress put additional pressure on the preexisting fault lines across the higher education landscape, as the new edition makes clear. For the 2022-2023 edition these top strategic issues include: (1) Ensuring institutional vitality; (2) Improving outcomes for students; (3) Strengthening civic education and democracy; (4) Grooming new higher education leaders; and (5) Managing serious risks. Framing questions for each issue are included to help guide the board's discussion toward strategic board conversations and deeper engagement about how these issues affect your institution.