Hypothalamic neural stem cells (htNSCs) are a type of glial-like neural stem cell located in the hypothalamus. They possess the ability to proliferate, differentiate, and migrate into the hypothalamic parenchyma, where they develop into neurons and integrate into neural circuits. htNSCs play a crucial role in regulating various physiological processes within the adult hypothalamus, including the formation of the blood-hypothalamic barrier (BHB), facilitating the diffusion of small molecules between the blood, cerebrospinal fluid, and hypothalamic parenchyma, sensing blood glucose levels, and regulating neuropeptide release. The aging of htNSCs significantly impacts energy metabolism, sex hormone secretion, and overall hypothalamic function. Transplanting younger htNSCs has been shown to alleviate neurological and skeletal muscle dysfunction associated with aging. In recent years, htNSCs have garnered widespread attention from researchers due to their roles in energy metabolism and their influence on the aging process. This article briefly discusses the classification of htNSCs, the effects of htNSC aging on bodily functions, their association with related diseases, and the regulatory mechanisms that promote htNSC regeneration. Certain interventions that enhance htNSC regeneration and mitigate their aging appear to influence the overall aging phenotype of organisms. In-depth research on htNSC aging may provide valuable insights into the hypothalamus’s role in systemic aging, the gender differences in aging, and offer new approaches and therapeutic targets for managing energy metabolism disorders and treating diseases related to gonadal hormone abnormalities.