Telomerase expression is restricted to a few cell types of the adult organism, most notably germ cells and stem/progenitor cells. Telomerase activity in germ cells is sufficient to prevent telomere shortening with age. Stem cells, however, do not have sufficient telomerase to prevent telomere shortening associated with continuous tissue renewal with increasing age. Indeed, telomerase levels in the adult organism are thought to be rate-limiting for longevity. This is supported by rare human syndromes caused by mutations in telomerase components, which are characterized by premature loss of tissue renewal and premature death. More recently, the role of telomerase and telomere length in stem cells is starting to be elucidated.