Chapter 15 argues that familial relationships between adult children and their older parents are crucial to the well-being of older adults worldwide. In Chinese society, as elsewhere, adult children are the most important sources of emotional, instrumental, and financial support for elderly parents. With longer life expectancy and smaller family size in contemporary China, the Chinese population has been experiencing a rapid aging process. There is evidence that the rate of infertility is rising, as more and more couples choose not to have children, millions may never be able to marry, and millions of parents have lost their single child. As a result, the number of Chinese childless seniors is on the rise. Further, individual pathways toward childlessness also vary. Their psychological and physiological health has become a serious concern for scholars and practitioners alike. Nevertheless, the author points out, research on childlessness and the well-being of childless seniors in China is limited. For example, we do not know how non-marriage and the adoption of children has contributed to the prevalence of childlessness. Nor do we know how childless elders _ be they infertile, unmarried, voluntarily childless, or having lost their children _ differ in their physical and psychological well-being. Nor do we have a ready set of tools to improve the well-being of childless seniors. To narrow these knowledge gaps, this chapter reviews the scholarly literature on childlessness in China, focusing on the demography of childlessness and pathways toward childlessness, physical and psychological well-being of childless seniors and individual coping strategies and social policy development in this chapter.