Pancreatic islet cell regeneration is considered to be important in the onset and progression of diabetes and as a potential cell therapy. Current hypotheses, largely based on rodent studies, indicate continuous turnover and plasticity of α‐ and β‐cells in adults; cell populations in rodents respond to increased secretory demand in obesity (30‐fold β‐cell increase) and pregnancy. Turnover and plasticity of islet cells decrease in mice within >1 year. In man, morphometric observations on postmortem pancreas have indicated that the cellular expansion is much smaller than the increased insulin secretion that accompanies obesity. Longevity of β‐cells in humans >20–30 years has been shown by ¹⁴C measurements and bromo‐deoxyuridine (BrdU) incorporation and there is an age‐related decline in the expression of proteins associated with cell division and regeneration including cyclin D3 and PDX‐1. Quantitative estimation and mathematical modelling of the longevity marker, cellular lipofuscin body content, in islets of subjects aged 1–84 years indicated an age‐related increase and that 97% of the human β‐cell population was established by the age of 20. New data show that human α‐cell lipofuscin content is less than that seen in β‐cells, but the age‐related accumulation is similar; lipofuscin‐positive (aged) cells form ≥95% of the population after 20 years. Increased turnover of cellular organelles such as mitochondria and endoplasmic reticulum could contribute to lipofuscin accumulation with age in long‐lived cells. Induction of regeneration of human islet cells will require understanding of the mechanisms associated with age‐related senescence.