Three distinct therapeutic approaches now target cellular senescence: senolytics like dasatinib plus quercetin eliminate damaged cells, senomorphics such as rapamycin suppress inflammatory secretions, and senoreversion uses epigenetic reprogramming to rejuvenate aged cells. Parallel metabolic interventions including spermidine, α-ketoglutarate, and ergothioneine function as caloric restriction mimetics, enhancing mitochondrial performance and activating cellular cleanup mechanisms. This represents a fundamental shift from treating aging symptoms to targeting root mechanisms across multiple pathways simultaneously. The convergence with AI-driven drug discovery accelerates compound identification and enables personalized interventions based on individual aging profiles. While promising in preclinical models for extending both lifespan and healthspan, these approaches face significant hurdles in clinical translation, including target specificity challenges and potential off-target effects. The emergence of precision longevity medicine marks a paradigm shift toward treating aging as a modifiable condition rather than an inevitable decline, though robust human trials remain essential to validate these mechanistic interventions.