There is strong evidence that regular physical activity reduces risk of cardiovascular disease. Building on the evidence review for the 2008 Physical Activity Guidelines for Americans, this article summarizes the recommended amounts and types of physical activity for the primary prevention of cardiovascular disease in older adults. Key guidelines are largely based on current understanding of the dose-response relationship between amount of physical activity and risk of chronic disease. In part due to the preventive effects on cardiovascular disease, physical activity has beneficial effects on functional limitations and health-related quality of life in older adults. Gaps in research on physical activity and cardiovascular health are discussed, with an emphasis on the need for research on how sedentary time affects risk of cardiovascular disease and other chronic illnesses.