High telomerase expression is a hallmark of most types of cancer, and, therefore, strategies to inhibit telomerase as an anticancer treatment have been pursuit for many years. In contrast to cancer, short telomeres and lack of telomerase are associated with aging and age-related disease, including heart disease. Consequently, pharmacological telomerase activation can delay aging and also provides cardioprotection. In this viewpoint, we briefly summarized the 2 faces of telomerase in cancer and during aging. We discuss why we see the therapeutic future in telomerase activation rather than its inhibition, for the treatment of cardiac disease and possibly even in the context of cancer.