Interviews from over a thousand CEOs in 2008 show organizations are bombarded by change, and many are struggling to keep up. CEOs view increasingly demanding customers not as a threat, but as an opportunity to differentiate. They are moving aggressively toward global business designs with deeply changing capabilities and increased flexibility. The gap between their capability to manage change and the challenge ahead is growing. CEOs expect fundamental change, but they seem uncertain about their organization's ability to manage it. Business pressures are compounding as IT constraints are growing.