This chapter reviews a wide range of literature on the “sandwich generation.” Women and men in the sandwich generation are caregivers to their young and older children as well as to one or both parents while managing their own household and work responsibilities. Sandwiched individuals report high levels of stress – physical, emotional and financial. Most sandwiched people are in their 50s and 60s. The sandwich generation is projected to grow dramatically over the next 30 years. Employed caregivers need to make work-related adjustments to undertake care. One response is to work fewer hours. Women undertake more caregiving than do men. The sandwich generation is a worldwide phenomenon with wide country differences in the levels and types of support available to caregivers. The caregiving relationship is complex, involving gender of caregiver, parents and parents-in-law, ethnic differences, resident versus non-resident caregivers, and changes in the relationship over time, sometimes involving Alzheimer’s and dementia. But there are benefits to caregivers as well, including improved relationships, using skills and developing new skills, and generously giving to another. Organizations need to address increases in caregiving among their employees and develop policies and initiatives that support these valued employees. Examples of such initiatives are described. There is also a need at the country level to integrate employees, communities, employers, businesses and levels of government to deal with this increasing trend. Key words: definition of sandwich generation, strains and benefits of caregiving, organizational challenges, supportive organization and government interventions.