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2003 Honda Accord engine is cranky when starting

My Honda has 53,000 miles and it has begun turning over rough when I first start it up in the morning. Once started it’s fine. Any suggestions on what to do?

Start by listing any history of problems that might be related and those you you don't see how they might be related. Manual or automatic transmission?

Have you kept up all the recommended maintenance?  How about the transmission fluid, has it ever been changed and the filter cleaned?  When was the last time you changed the plug wires? Air cleaner?  etc.

More specific, how long does it run rough when you start it in the morning?  10 seconds or 10 minutes?  

Have you had any CELs (Check Engine Lamp)?

“Turning over rough” is hard to decipher.

Would you say that when you turn the key it sounds “tired” or “sluggish.” Instead of an excited and powerful RRR.RRR…RRR…FIRE UP its gives you a wimpy and hesitant rrrrr…rrr…rr.r…? (It is, afterall, hard to describe what this sounds like in text).

If its that kind of thing then you probably need a new battery. Many auto parts stores test the systems for free and so free battery installs (obviously if you buy it from them).