The more years of physical education (PE) class students in Taiwan experience, the less regular exercise they perform. There are 161 universities/colleges nationwide, 132 of which require 2 years of PE. Only 35 designated PE as part of graduation credit. Without official PE evaluation, universities/colleges reduce their PE requirements. The purpose of this article was to explore the difficult position and future reform strategies of PE classes at universities/colleges based on perspectives of cognitive development, learning theory, scientific research, societal needs and student's occupational preparation. The method required a review of annual report, statistical data, meeting minutes, proposals and conference papers, and searches of literature via PubMed, Medline and Google. The latter involved searching on key words such as physical education, exercise, physical activity, cancer, cardiovascular diseases, and myokine. After these various resources were compiled and discussed, generalizations and conclusions were drawn. The results revealed that as a student develops, his or her prefrontal lobe is maturing, requiring new information and knowledge as a foundation for judging various behaviors. Mounting and persuasive evidence from scientific research on the health benefits of exercise suggests that fostering the practice of regular exercise in PE class at university/college and teaching relevant skills are vital for students. Conducting fitness self-training and helping elder family members exercise using knowledge and skills gained at school also helps improve students' employability and meets a societal need. A recommended teaching content of PE is proposed.