OBJECTIVE Among a growing number of articles about spirituality and medicine, there are no open-ended empirical inquiries about family physicians' understanding of spirituality and what it might mean to incorporate spirituality into family practice. We used a qualitative methodology to investigate family physicians' perceptions of spirituality in clinical care, the roles of their own personal spirituality, and implications for medical education. METHODS We used qualitative content analysis on transcripts of semi-structured interviews that had been conducted with 12 family physicians, in three regions of the country, with an expressed interest in spirituality. RESULTS This group of physicians reported 1) taking a vital clinical role as encouragers of patients' spiritual resources, 2) a vital role of their personal spirituality as an underpinning of the vocation and practice of family medicine, and 3) the key roles of respectful dialogue and mentoring in medical education about spirituality. CONCLUSIONS Results affirm the significance of spirituality in clinical family practice for the subjects interviewed and support a tripartite model that embraces clinical approaches to the spirituality of patients and families, the spirituality of caregivers, and the qualities of spirituality in health care organizations.