Physical activity is a powerful intervention that addresses physiologic and functional changes stemming from age, pathology, as well as recovery from injury and illness. However, only 9% of older adults complete the recommended amounts and types of physical activity weekly. This article provides a step-by-step process for initiating a physical activity program with individuals who are starting from a baseline of little to no activity. In addition, this article reviews quantifying baseline levels of physical activity, identifying what matters most, determining readiness to perform physical activity, developing goals, creating an action plan, addressing barriers, assessing self-efficacy, and follow-up for challenges.