Continuing education is vital for otolaryngologists to maintain and build on their knowledge base and skill sets. This article discusses the history of continuing medical education (CME) and describes the significant changes in CME that are currently underway. The development of CME has generally lagged behind other improvements in medical education. After a gradual evolution, however, CME is now incorporating many of the principles that are driving undergraduate and graduate medical education--namely, adult learning theory and technology-intensive applications. As attention is focused on maintaining physician competency and eliminating medical errors, CME is becoming more highly regulated, and CME providers are being held to higher standards. The future will see an increased emphasis on the effect of CME activities on altering physician behavior and improving patient outcomes.