Ageism in healthcare is a pervasive reality that leads to negative health outcomes for older adults. While it is often implicit, the COVID-19 pandemic threw explicit age discrimination in healthcare into sharp relief globally. In medicine, ageism translates into myriad forms of age discrimination that impact the provision of ethical care and range from 'micro' individual issues like paternalistic medicine or therapeutic nihilism to 'macro' system issues including barriers to timely and effective healthcare or exclusion from research trials. The culture of ageism in medicine can be unintentionally transmitted through role-modelling and the hidden curriculum. Strategies to combat ageism and provide ethical healthcare include intergenerational learning, educational programs, and strong leadership from organizations to enact policy and practice changes.