Caring for older adults is often seen as less prestigious, less attractive, and even boring and frustrating by health care students. A cross-sectional study of 265 paramedical students examined their fear of death, anxiety about aging, knowledge of aging and gerontological care, perceptions of older adults, and how these factors relate to ageist attitudes and perceptions of working with older adults using path analysis. The study found that anxiety about aging, negative perceptions of older adults, and limited knowledge of aging and gerontological care were directly linked to hostile ageist attitudes. Fear of death indirectly influenced hostile ageist attitudes through negative perceptions of older adults. Additionally, anxiety about aging, hostile ageist attitudes, and negative perceptions of older adults were linked to negative perceptions on working with older adults. Benevolent ageist attitudes were not linked to negative perceptions of working with older adults but were associated with negative perceptions of older adults and less knowledge of aging. These findings suggest that enhancing students' knowledge and changing their perceptions of older adults and the aging process could effectively combat ageism in health care. Addressing ageist attitudes is crucial, as they are significantly associated with negative perceptions of working with older adults.