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Iran's Supreme Leader gravely wounded but mentally sharp, engaged: 4 officials tell NYT
President Masoud Pezeshkian, who is a heart surgeon, and the minister of health have both been involved in his care
- PUBLISHED: Thu 23 Apr 2026, 7:42 PM
[Editor's Note: Follow Khaleej Times live blog for the latest regional developments with the US-Israel-Iran ceasefire now in effect.]
When Ayatollah Ali Khamenei ruled Iran as the supreme leader, he exerted absolute power over all decisions about war, peace and negotiations with the United States. His son and successor does not play the same role.
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Ayatollah Mojtaba Khamenei, the son, is an elusive figure who has not been seen and whose voice has not been heard since he was appointed in March. Instead, a battle-hardened collective of commanders in Iran’s Revolutionary Guard and those aligned with them are the key decision-makers on matters of security, war and diplomacy.
“Mojtaba is managing the country as though he is the director of the board,” said Abdolreza Davari, a politician who served as senior adviser to Mahmoud Ahmadinejad when he was president and knows Khamenei.
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“He relies heavily on the advice and guidance of the board members, and they collectively make all the decisions,” Davari said in a phone interview from Tehran. “The generals are the board members.”
This account of Iran’s new power structure is based on interviews with six senior Iranian officials, two former officials, two members of the Revolutionary Guard, a senior cleric familiar with the inner workings of the system and three individuals who know Khamenei well. Nine other individuals with ties to the Guard and the government also described the command structure. They all spoke on the condition they not be identified because they were discussing sensitive matters of state.
Khamenei, who was selected by a council of senior clerics as the new supreme leader, has been in hiding since US and Israeli forces bombed his father’s compound February 28, where he also lived with his family. His father, wife and son were all killed. Access to him is extremely difficult and limited now. He is surrounded mostly by a team of doctors and medical staff who are treating the injuries he sustained in the airstrikes.
Senior commanders of the Guard and senior government officials do not visit him, fearing that Israel may trace them to him and kill him. President Masoud Pezeshkian, who is also a heart surgeon, and the minister of health have both been involved in his care.
Though Khamenei was gravely wounded, he is mentally sharp and engaged, according to four senior Iranian officials familiar with his health. One leg was operated on three times, and he is awaiting a prosthetic. He had surgery on one hand and is slowly regaining function. His face and lips have been burned severely, making it difficult for him to speak, the officials said, adding that, eventually, he will need plastic surgery.
Khamenei has not recorded a video or audio message, the officials said, because he does not want to appear vulnerable or sound weak in his first public address. He has issued several written statements that have been posted online and read on state television.
Messages to him are handwritten, sealed in envelopes and relayed via a human chain from one trusted courier to the next, who travel on highways and back roads, in cars and on motorcycles until they reach his hideout. His guidance on issues snakes back the same way.
The combination of concern for his safety, his injuries and the sheer challenge of reaching him has resulted in Khamenei delegating decision-making to the generals, at least for now. Reformist factions, as well as ultra-hard-liners, are still involved in political discussions. But analysts say that Khamenei’s close ties to the generals, whom he grew up with when he volunteered to fight in the Iran-Iraq war as a teenager, have made them the dominant force.
President Donald Trump has said that the war, along with the killings of layers of Iran’s leaders and security establishment, has ushered in “regime change” and that the new leaders are “much more reasonable.” In reality, the Islamic Republic has not been toppled. Power is now in the hands of an entrenched, hard-line military, and the broad influence of the clerics is waning.
“Mojtaba is not yet in full command or control,” said Sanam Vakil, the director of the Middle East and North Africa for Chatham House, who has contact with people in Iran. “There is, perhaps, deference to him. He signs off or he is part of the decision-making structure in a formal way. But he is presented with fait accompli presentations right now.”
The speaker of the Iranian parliament, Mohammad Bagher Ghalibaf, a former Guard general and the lead negotiator with the United States in Pakistan, said in a television address Saturday that the US proposal for a nuclear deal and peace plan and Iran’s response had been shared with Khamenei and his views taken into account when making decisions.