Although the older population as a whole is increasing faster than any other age group, the most dramatic growth is in the oldest old. Centenarians, those individuals who have survived 100 or more years, have increased ten times in size over the past forty years. This population trajectory is expected to accelerate even more into the next century. Unfomately, social work with the older population rarely includes practice issues related to work with these older adults who have survived well past the average lie expectancy. This article provides a description of the current cohort of centenarians from a biopsychosocial framework and presents an agenda for social work practice, policy and research.