The recent debate in the United States' gerontological literature on ‘anti-ageing medicine’ has profound significance for the discipline of gerontology. This review article discusses three major contributions to the debate and assesses the meaning of the wider debate for gerontology. A paper by Olshansky, Hayflick and Carnes, published in the Scientific American in May 2002, aimed at a popular science readership rather than gerontologists and had an overtly campaigning purpose. Among the many responses to the paper, that by Robert H. Binstock in The Gerontologist in February 2003 places the concerns expressed by Olshansky et al. in an historical context, and draws out its significance for gerontology as a discipline. Binstock believes that the central issue is legitimacy. What characteristics distinguish scientific endeavour that seeks an understanding of the fundamental biology of human ageing from quackery and pseudo-science? Does the ‘anti-ageing movement’ have a place in legitimate science? Also reviewed is a special issue of Generations, the journal of the American Society on Aging, on ‘Anti-Aging: Are You For It Or Against It?’. Amongst other distinguished contributions, the leading moral philosopher of old age, Harry Moody, explores key issues in ‘Who's afraid of life extension?’ The debate represented by these papers is significant not only for bio-medical but also social gerontology and for our understanding of the cultural position of old age in modern society.