Chronic diseases are strongly associated with premature death and increased health care costs. Nearly half of American adults report they have one or more chronic health conditions. Cooperative Extension is calling for refocus to refine and align with broader efforts to promote public health by supporting the prevention and management of chronic disease. The success of this refocus is dependent on a shared vision between funding agencies, stakeholders, and Extension. As part of developing this shared vision, the Chronic Disease Health Implementation Team surveyed 152 Extension administrators, faculty, and Extension Agents/Educators to determine their perception of the role of Extension in chronic disease prevention and management in the next century. Respondents answered the open-ended question, "What role should Cooperative Extension have in working to reduce chronic diseases in America for the next 10, 25, and 100 years?" Analysis with grounded theory identified three themes. The respondents perceived the role of Extension professionals as educators and collaborators in chronic disease prevention and management who focus on influencing individuals and environments. As educators, Extension should deliver evidence-based programs to communicate, inform, facilitate, and teach. As collaborators, Extension should facilitate and nurture partnerships to effect changes in chronic disease prevention and management at individual, family, and community levels.