Today’s universities are facing historic challenges, including declining enrollments and revenue from tuition and philanthropy, growing debt, and the changing expectations of prospective students, parents, and the public. While the factors leading to this moment affect many institutions, including large public universities and systems, small and mid-sized private institutions are especially at risk. In this session, six university presidents will share their experience and wisdom about how they faced existential challenges and either survived, merged, affiliated or closed. Given the growing need for institutions to make profound change or cease to exist, we believe that there will be great interest. We hope to inspire leaders to take smart and timely action to achieve the best outcome for their institution.