Adipose tissue, categorized into white (WAT) and brown (BAT) adipose tissue, plays a variety of roles including energy storage, and thermal regulation, with functions depending on the body region. With aging, overall adipose tissue mass increases initially but again decreases in the late stages of life. Generally, the age-related changes in adipose tissue can be summarized under the term “fat centralization” which involves the redistribution of fat from peripheral subcutaneous depots to central visceral depots. This shift is associated with increased morbidity through metabolic disorders. However, aging affects the adipose tissue not homogeneously across the body but rather region dependent: In the abdomen, subcutaneous fat decreases, while visceral fat increases. Extremities show reduced subcutaneous fat and increased muscle fat infiltration. The facial fat compartments “deflate” through volume loss, resulting in typical aging signs, while the torso shows a fatty replacement of breast tissue and variable changes in epicardial and intramyocardial fat. Bone marrow fat increases and replaces hematopoietic cells, particularly in central bones since peripheral bones exhibit high fat contents already in early years. Understanding these changes is pivotal for developing treatments to reduce metabolic disorders and improve aesthetic and reconstructive procedures. Future research should explore these mechanisms to promote healthy aging strategies.