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Physicians are accustomed to prescribing multiple prescriptions to adults of all ages, but particularly to the older adult population. In 2010, US retail pharmacies filled out on average 31.1 prescriptions for adults aged 65 years and older compared with 11.3 prescriptions to adults aged 19–64 years. Older adults find themselves at the pharmacy counter more often than younger generations due to an increase in chronic diseases and disabling conditions. Many of these diseases and conditions are often well treated and controlled via prescription drugs. However, a different type of prescription should be written on physicians' prescription pads worldwide, one that could potentially lower the risk of diseases and disabling conditions altogether. This prescription is commonly referred to as an ‘exercise prescription’. The overall intent of this paper is to discuss successful strategies implemented by physicians who have prescribed physical activity/exercise to their older adult patients and to help healthcare providers better understand and establish successful exercise prescription counseling habits. It is also aimed to shed light on the barriers facing primary care providers in an effort to help physicians overcome these barriers. Information regarding Exercise is Medicine® and the Exercise is Medicine® Credential program for exercise specialists is provided. Older adult and public health advocates will also find this paper valuable in that they too will learn the recommended physical activity guidelines, associated benefits of engaging in the recommended dose of physical activity, and perhaps how to promote exercise prescription by their physician, physician organizations, or engage other members of the medical team, including health and fitness professionals, to strive for a common goal of patients receiving this ‘new’ medicine called exercise.