This article presents the assumption that the 21st century will have characteristics that are important to occupational therapists and the persons they serve. These characteristics include increases in chronicity, knowledge of human purpose, complexity of living, emphasis on personal power, awareness of demands from the environments where persons live and work, and a new conceptualization of health as persons’ capacities to achieve goals through a repertoire of skills. The 21st century can lead into the millennium of occupation because occupational therapists can help persons become their own agents of competency, remove social barriers to their self-definition, and thrive in their environments.