On 9 September 2008, various sources reported that after he did not show up that day for a military parade celebrating North Korea's 60th anniversary, United States intelligence agencies believed Kim might be "gravely ill" after having suffered a stroke. He had last been seen in public a month earlier.
By 29 October 2008, reports stated Kim suffered a serious setback and had been taken back to hospital. The New York Times reported that Japanese Prime Minister Taro Aso, on 28 October 2008, stated in a parliamentary session that Kim had been hospitalized: "His condition is not so good. However, I don't think he is totally incapable of making decisions". Aso further said a French neurosurgeon was aboard a plane for Beijing, en route to North Korea. Further, Kim Sung-ho, director of South Korea's National Intelligence Service, told lawmakers in a closed parliamentary session in Seoul that "Kim appeared to be recovering quickly enough to start performing his daily duties". The Dong-a Ilbo newspaper reported "a serious problem" with Kim's health. Japan's Fuji Television network reported that Kim's eldest son, Kim Jong-nam, travelled to Paris to hire a neurosurgeon for his father, and showed footage where the surgeon boarded flight CA121 bound for Pyongyang from Beijing on 24 October. The French weekly Le Point identified him as Francois-Xavier Roux, neurosurgery director of Paris' Sainte-Anne Hospital, but Roux himself stated he was in Beijing for several days and not North Korea. On 19 December 2011, Roux confirmed that Kim suffered a debilitating stroke in 2008 and was treated by himself and other French doctors at Pyongyang's Red Cross Hospital. Roux said Kim suffered few lasting effects.
On 5 November 2008, the North's Korean Central News Agency published 2 photos showing Kim posing with dozens of Korean People's Army (KPA) soldiers on a visit to military Unit 2200 and sub-unit of Unit 534. Shown with his usual bouffant hairstyle, with his trademark sunglasses and a white winter parka, Kim stood in front of trees with autumn foliage and a red-and-white banner. The Times questioned the authenticity of at least one of these photos.
In November 2008, Japan's TBS TV network reported that Kim had suffered a second stroke in October, which "affected the movement of his left arm and leg and also his ability to speak". However, South Korea's intelligence agency rejected this report.