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We summarize the key findings, strength of the evidence, and research needs identified in the National Institutes of Health conference “Vitamin D and Health in the 21st Century: an Update,” which was held in September 2007; a systematic evidence-based review; and a National Institutes of Health roundtable discussion held after the conference by scientists with relevant expertise. The evidence-based review addressed 5 questions on 25-hydroxyvitamin D [25(OH)D] and functional outcomes across the life cycle and response to exposure, bone health outcomes of supplementation, risks and benefits of sun exposure, and adverse outcomes. These questions also framed the conference and roundtable discussions. Researchers have made considerable progress in understanding the relation of 25(OH)D to bone health outcomes in the elderly and in postmenopausal women, but we know less about its impact on …