Makoto Kuro-O grew up in Tokyo, the younger of two children. His father was an engineer, providing air conditioning systems for large structures like the Tokyo train stations. His mother went to college but did not work after she married. At an early age Kuro-O decided he liked science. He attended the local elementary and junior high schools, but a national high school. His high school chemistry and physics teachers were enthusiastic about their subjects and helpful to Kuro-O. At this point he contemplated becoming a doctor; he talks about the higher education system in Japan, his experience getting into medical school, his parents' expectations. He entered medical school at University of Tokyo. Because his father had a heart attack during Kuro-O's second year in medical school, Kuro-O became interested in cardiology and describes his first basic laboratory experience. He did his PhD while spending at least half of his time seeing patients. He met Ryozo Nagai and joined his lab at Tokyo University. Here he discusses his funding; Nagai's research interests; publishing articles; and his postdoctoral work in genetics at the National Institute of Neuroscience of Japan on the age-suppressor gene in mice. During his last year of internship Kuro-O met and married his wife. Kuro-O then accepted a position at the University of Texas Southwestern Medical Center. He talks about his move to the United States; setting up his laboratory; funding in general and specifically the impact of the Pew Scholars Program in the Biomedical Sciences on his work; his lab management style; his teaching responsibilities; and his research on the age-suppressor gene. Next Kuro-O discusses a little more of his research on the age-suppressor gene, his current research on the anti-aging protein and renal disease, and practical applications of his research. Kuro-O then moves on to talk about his future research on the functions of the Klotho protein and about his collaborations, tenure at University of Texas Southwestern Medical Center, his administrative duties, his role in the lab, the running of his laboratory, the process of writing journal articles, and patents. He also describes a typical work day. The interview concludes with Kuro-O's comments on collaborations in science, serendipity in his work, gender and ethnic issues in science, his first impressions of the United States, and a comparison of science in Japan and the United States.