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How does leader age affect international politics? Challenging a literature preoccupied with “objective” age, we argue that leaders do not age the same in the eyes of their beholders. Combining insights from gerontology and studies of face-to-face diplomacy, we show that judgments about age informed by high-level personal encounters have profound consequences for how elderly leaders are appraised and treated by their counterparts. A leader who betrays indicators of “senility” during face-to-face encounters will elicit harsh judgments by activating negative stereotypes about aging. Older leaders can also surprise their interlocutors: those long thought to be senile may show themselves as mentally and physically fit. Perceptions of age shape how observers understand a leader’s agency, or their capacity to produce reasoned decisions and execute role-specific authorities. Assessments of agency, in turn, shape decisions to engage, bypass, or subvert the leader in question. We compare American views of two elderly leaders during the Cold War—South Korea’s Syngman Rhee and China’s Mao Zedong—and how those views changed over time, finding powerful support for our arguments. Our findings suggest new insights for the “first image” research program in IR as well as practical lessons for statecraft in an era of aging leaders.