The protein Klotho was first discovered in Klotho-deficient mice, which developed a syndrome similar to premature aging in humans. Since then, Klotho has been implicated in multiple molecular signalling pathways and diseases. Wnt activity and signalling pathways related to ageing and senescence: progerin, klotho and mTOR. Klotho has three different forms: soluble, membrane bounded and intracellular Klotho. All these three forms have different function. Klotho has been shown to have anti-aging, health span and lifespan extending, cognitive enhancing, anti-oxidative, anti-inflammatory, and anti-tumor properties. Two of three forms of Klotho protein, membrane Klotho and secreted Klotho, exert distinct functions. Membrane Klotho forms a complex with fibroblast growth factor receptors and functions as an obligate co-receptor for FGF23, a bone-derived hormone that induces phosphate excretion into urine. Mice lacking Klotho or FGF23 not only exhibit phosphate retention but also display a premature-aging syndrome, revealing an unexpected link between phosphate metabolism and aging. Secreted Klotho functions as a humoral factor that regulates activity of multiple glycoproteins on the cell surface, including ion channels and growth factor receptors such as insulin/insulin-like growth factor-1 receptors. Potential contribution of these multiple activities of Klotho protein to aging processes is discussed. Klotho levels decrease with age and in many diseases. It has been of great interest to develop a Klotho-boosting or restoring drug, or to supplement endogenous Klotho with exogenous Klotho genetic material or recombinant Klotho protein, and to use Klotho levels in the body as a biomarker for the efficacy of such drugs and for the diagnosis and management of paediatric diseases. First efforts were performed in mice and humans to add orally active and clinically translatable senolytics like Dasatinib or Quercetin to restore Klotho levels. Further research in this interesting field of Klotho interaction in growth and aging in children, especially in paediatric premature aging syndromes, is necessary. This is an overview of the role of Klotho in paediatric premature diseases.do not exhibit all aspects associated with physiological aging. Premature aging signs include, among others, alopecia, hair graying, lipodystrophy, osteoporosis, joint contractures, cataract, hearing loss, atherosclerosis, cardiovascular diseases, diabetes mellitus and malignancies at an early age. In addition to these typical aging phenotypes, progeria patients may also present with growth retardation, developmental delay, and intellectual disability. A more modular view of segmental premature aging syndromes hypothesizes that a cluster of symptoms appearing in several disorders might be due to a common underlying cause-for example, alopecia, osteoporosis, and nail atrophy have been proposed to be related to telomere shortening. Research into premature aging disorders