We show how the properties of the QCD axion change in systems at finite baryonic density, such as neutron stars. At nuclear saturation densities, where corrections can be reliably computed, we find a mild reduction of the axion mass and up to an order of magnitude enhancement in the model-independent axion coupling to neutrons. At moderately higher densities, if realized, meson (kaon) condensation can trigger axion condensation. We also study the axion potential at asymptotically large densities, where the color-superconducting phase of QCD potentially leads to axion condensation, and the mass of the axion is generically several orders of magnitude smaller than in vacuum due to the suppressed instantons. Several phenomenological consequences of the axion being sourced by neutron stars are discussed, such as its contribution to their total mass, the presence of an axionic brane, or axion-photon conversion in the magnetosphere.