Telomerase is a specialized enzymatic complex responsible for the synthesis of telomeric repeats 5'-TTAGGG-3' localized at the ends of eukaryotic chromosomes. This mechanism prevents shortening of telomeres after each cell division. The enzyme is detected in about 85% of human tumors, but it is not expressed in normal cells or its expression is significantly lower. Consequently, it provides the cancer cells immortality. Thus, since showing cancer cell specificity (to a certain extent), the enzyme became a target for an adjuvant cancer therapy. So far, in vitro studies and preclinical studies seem to be promising. This work focuses on the pathways and mechanisms that are targeted in order to eliminate telomerase with consequence of cancer cell death. The anti-telomerase strategy may be beneficial especially in the context of sensitization of tumor cell to chemotherapeutic agents. We also indicate potential side effects and consequences of telomerase downregulation that should be considered when anti-telomerase strategy is undertaken. Alternatively, we also emphasize potential useful application of telomerase induction.