Oxygen is a double-edged sword. Despite the near universal requirement for oxygen for survival and reproduction in animals, oxygen and oxidative metabolism are responsible for the production of reactive oxygen species (ROS), which has, until recently, been considered a cellular toxin and a major cause of aging. Alterations in environmental oxygen can alter rates of aging and ROS production in many organisms. Animals coordinate the cellular response to low oxygen with a conserved hypoxic response mediated by the hypoxia inducible transcription factor, hypoxia-inducible factor (HIF). In addition to hypoxia, HIF has been shown to have roles in aging, cancer, cardiovascular disease, and stem cell maintenance in organisms from worms to humans. Furthermore, HIF has been shown to interact with mechanistic target of rapamycin (mTOR), Sirtuins, and to infl uence other pathways and interventions known to affect the aging. This chapter focuses on the effects of altered oxygen concentrations on the aging, its similarities to dietary restriction, how mutations in the HIF pathway affect lifespan and health span, and how the HIF pathway interacts with other conserved longevity pathways.