Physical activity is fundamental for achieving healthy aging. Exercise offers older adults substantial benefits, such as reducing risks of all-cause mortality and chronic disease, preserving functional capacity, improving management of chronic conditions, and reducing health-care costs. Given the prevalence of physical inactivity and sedentary behavior among adults 65 and over, exercise needs to be more thoroughly integrated into care plans and counseling in primary care settings. A practical, three-step approach to exercise counseling is recommended. Older adults should strive to do at least 150 minutes of moderate-intensity aerobic exercise weekly, muscle-strengthening and flexibility activities twice weekly, and for those at risk of falls or with mobility problems, balance activities at least three times per week. Older adults with functional restrictions or chronic conditions should be as physically active as their abilities and conditions allow. Any amount of moderate-to-vigorous physical activity gains some health benefits. Appropriate physical activity counseling, prescription, and referral must be tailored for each patient and must take into account such factors as fitness levels, goals and motivations, access to exercise-related facilities and programs, chronic diseases, prescribed medications, common injuries, and hip and knee arthroplasties.