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In response to the rapid growth of the assisted living (AL) residents, this article considers the resulting range of roles, opportunities, and challenges physicians may face as increasing numbers of their older adult patients choose residence in AL facilities. The problem is framed by providing an overview of the AL industry and reviewing AL resident demographics and health status characteristics. The discussion section examines the pervasive involvement of physicians with AL residents, reviews professional position statements on health care in AL, and reviews the emerging AL-focused clinical literature. In conclusion, the paper proposes key elements of a research agenda including establishing baseline physician-AL activity levels, physician collaboration with mid-level practitioners, and exploring physician involvement in chronic care and health promotion in AL.