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The last two decades have made it possible to understand the role of telomeres in the aging process and in longevity via their direct influence on replicative senescence and the capacity for tissue repair. Telomere length is primarily determined by genetic factors and secondarily by the influence of environmental factors during the first years of life. Short telomeres have a causal role in the development of age-related degenerative diseases and reduced longevity. Therefore, telomere length can be considered as a “biological capital” formed early in life, which plays an important role in the damage/repair balance at the cellular and tissue level and can thus influence the trajectory of aging. The integration of telomere length into a set of clinical, biological, and social data would make it possible to better individualize strategies for the prevention of age-related diseases, frailty, and loss of autonomy.