When Presidents Barack Obama and Dmitry Medvedev meet for the first time on Wednesday, a big part of what Washington calls "pressing the reset button" will be to rescue the two countries' dying arms control treaty and prevent a return to Cold War nuclear rivalry.
The "reset" sought by the Obama administration to define future US-Russian relations covers a tangle of issues. Critical among them is the replacement of one of the most important Cold War deals limiting the world's two largest nuclear arsenals - the Strategic Arms Reduction Treaty.
START expires on December 5, and at their London summit, Obama and Medvedev are expected to announce talks on a new pact, whose outcome will colour relations between Washington and Moscow for years to come.
But with an array of military and political issues to untangle, "the process will be very difficult", said Anton Khlopkov, director of the Moscow-based Centre for Energy and Security Studies.
Signed in 1991 by Soviet President Mikhail Gorbachev and President George HW Bush, the 700-page START resulted in the largest nuclear reductions in history. Essential to the treaty was a mechanism that allowed the two sides to inspect and verify each other's arsenals.
"If one thing or another isn't done, then we'll end up in a legal vacuum and we won't know anything about the condition of (each other's) nuclear forces," said retired Maj Gen Vladimir Dvorkin, a former arms control expert with the Russian Defence Ministry.
According to the US State Department, Russia had about 4,100 warheads available for use on missiles based on land, on submarines and on long-range bombers as of last July - the most recent official data available. The United States had around 5,950. That includes warheads in storage - a major point of disagreement.
The talks are the first major arms control negotiations since 1997, when presidents Boris Yeltsin and Bill Clinton made a new push to reach a START successor treaty that US and Russian MPs would ratify.
That effort, however, was tied up for years by MPs in both countries and START II ultimately fell apart.
Instead, the two powers produced the 2002 Treaty of Moscow, a page-long document committing them to slash their warheads to between 1,700 and 2,200 in number. But it's considered far weaker than START.
With just eight months remaining before START expires, both Medvedev and Obama have signalled a desire to reach a new deal. Experts say the two nuclear giants could easily agree to cuts below 1,700 warheads, if not further.
But a thicket of technical disputes, differing interpretations and lingering grievances make it unlikely that negotiators will reach a comprehensive successor to START before the deadline, analysts say. More likely is that START will just be renewed or the two sides will reach an informal agreement that keeps some sort of arms control framework in place.
"I am not at all sure that the Kremlin actually wants to see the negotiations conclude quickly," Russian military commentator Alexander Golts wrote in a recent column, arguing that Moscow will use the talks to boost its battered prestige as an equal negotiating partner with Washington.
However Hans Kristensen, a researcher with the Federation for American Scientists in Washington, says both sides have good reason to want a deal. "The Russians have every interest in landing some sort of agreement here," he said. "And the US needs to cement a better relationship with Russians and turn this ship around."
Washington is looking to increase the number of strategic missiles it tips with non-nuclear warheads - for example, submarine-launched missiles that could be used to take out terrorist bases. Moscow argues that it would have no way of knowing whether such a submarine-launched missile is nuclear or not.
Russia, meanwhile, is developing the RS-24, a new type of missile that can carry multiple warheads. Washington says it's just an upgrade of an existing model, a violation of START.
The Russian military, however, has said the new missile will be deployed in December after START expires - a signal that Moscow has no intention of abiding by START's restrictions on that type of weapon.
Other thorny issues include the definition of "operationally deployed" missiles - whether a warhead on a shelf in storage, for example, should be considered "deployed" or not. The two sides differ strongly.
Russia has also said it wants cuts not only in warheads but also the missiles, bombers and submarines that carry them.
Also poisoning the atmosphere is the US missile defence plan for Eastern Europe. Moscow intends to put the plan on the negotiating table, calling it a threat to its strategic deterrent.
Another impediment is military doctrine. Drastic cuts in arsenals will require military planners in both countries to markedly change how and where missiles are deployed in their so-called "triads" - the three-pronged strategy to ensure missiles can be fired either from land or from the sea or from the air.
Nearly 20 years have passed since the superpowers declared the Cold War over, and the counting of warheads may sound like something out of a time capsule.
But to Deputy Foreign Minister Sergei Ryabkov, Moscow's point man on arms control, they are critical to mend the damaged US-Russian relationship
"To a certain extent, everything depends on how it goes with START," he told Echo Moskvy radio on Friday. "The times are different now, but these are weapons that have the most influence on the general condition of international relations and on Russian-American relations in particular."