Telomeres play a critical role in protecting chromosomes and have a profound impact on our health and longevity. While the potential to influence aging and health through telomere maintenance is tantalizing, it's a field still in its infancy, with much more to learn. From subtelomeric areas to telomeres, telomeric repeat containing RNA (TERRA) is transcribed. Telomeric dsDNA can be invaded by TERRA RNA, which then forms telomeric R-loop structures. An increasing amount of study points to the importance of TERRA-mediated R-loops in maintaining telomere length homeostasis and cell aging. Here, we provide an updated review of telomeres and R-loops, the factors that regulate telomeric R-loops, their interplay and potential contribution to the acceleration of aging, and the implications for delaying the aging process.