The health, illness, and life styles of the oldest Palauans were investigated by interview and examination in their homes. Thirty-eight citizens ranged in age from 86 to 111. Ten were 100 years or older. They were in unusually good physical and mental health. The most common physical problem is arthritis. Life style is described in terms of diet, physical activity, smoking and drinking habits, use of medical services, and living conditions. It is theorized that the characteristic physical limitations bring on a crisis of usefulness; role intention and respect may be critical developmental issues as well at this oldest age period of the human life span.