The "National Physical Activity Plan", as well as professional and government agencies (NASPE, 2008a; US Department of Health and Human Services, 2000) acknowledge pre-kindergarten (pre-K) children should be part of comprehensive school physical activity initiatives anchored in quality physical education programming. These recommendations come at a time when (a) state funded pre-K enrollments in 2010 exceeded more than 1.2 million children, (b) states are granting universal access to pre-K educational programming, and (c) there is a rapid increase in obesity among our nation's youngest children. Accordingly, physical education teacher education faculty may need to re-evaluate the extent to which graduates are prepared for delivering physical education programming to a younger group of learners. The article will examine the increasing prevalence of pre-K children in public schools, teacher preparation initiatives and concerns, and provide recommendations for preparing preservice physical education teachers.