Neurogenesis occurs in two germinal centres of the adult brain and persists with increasing age, although at a reduced level. This observation, that the mature brain can support neurogenesis, has given rise to the hope that neural stem cells could be used to repair the brain by repopulating regions suffering from neuronal loss as a result of injury or disease. The aging brain is vulnerable to mild cognitive impairment, increasing incidence of stroke, and a variety of neurodegenerative diseases. However, most studies to date have focused on the young adult brain, and relatively little information is available about the regulation of neurogenesis in the aged brain or the potential of using neural stem cells to repair the aged brain. This review summarizes the current state of knowledge on neurogenesis in the young adult brain and discusses the information available on age-related changes in neurogenesis. Possible therapeutic strategies using neural stem cells for repair of the aging brain are considered.