The health benefits of regular exercise are well documented, yet there has been limited success in the promotion of regular exercise in older African American women. Based on theoretical and evidence-based findings, the authors recommend a behavioral self-efficacy approach to guide exercise interventions in this high-risk population. Interventions should be developed that are age appropriate, group delivered in the community, focused on a single behavior, and only include general health education as a secondary purpose. Suggested cultural tailoring of exercise interventions includes addressing beliefs about exercise, focusing on the "possible self," promoting participants as "cultural consultants," and spiritual and religious strategies. (Contains 1 table and 1 figure.)