Aging is the predominant risk factor for major neurodegenerative diseases. The underlying mechanisms are largely unknown. Members of the sirtuin family of protein deacetylases support and promote longevity in diverse organisms and can extend lifespan when upregulated. Sirtuins are involved in fundamental mechanisms in age-related neurodegenerative diseases, including protein aggregation and homeostasis, survival and stress responses, and inflammatory processes. In this review,we will discuss the neurobiology of sirtuins and their multifaceted roles in the pathogenesis of neurodegenerative diseases. We will also examine the potential and challenges of targeting sirtuin pathways to treat these devastating conditions.