Why are graduate nursing administration (MSN/A) program enrollments declining? Do these programs truly meet the needs of potential students? Will they help them to be effective and innovative partners on the healthcare management team? The authors explore reasons for the decline in MSN/A enrollments, potential negative outcomes, and currently available alternative educational choices. They then suggest MSN/A program redesign and other courses of actions. Nurse administrators and nurse educators must be aware of these trends and have equal input into the creation of a viable MSN/A program that will be able to survive in the 21st century.