Chapter 17 claims that the Confucian norm of filial piety has been the cornerstone of the Chinese family. Under this cultural mandate, adult children have the moral responsibility for providing care and support, physically, financially, and emotionally, to their elderly parents. In China, the traditional family-based elder care system is being eroded by demographic shifts and socioeconomic changes in recent decades. China’s population is aging fast, and at the same time family size is shrinking and multigenerational households are waning. The availability of family caregivers is stretching thin, aggravated by increased population mobility and geographic dispersion of family members amid rapid urbanization and industrialization. Yet, China currently has a weak social safety net and is in the early stage of developing aged care services to meet the needs of an ever-increasing elderly population. This chapter discusses the continuity and changes in the age-old tradition of filial piety in a fast-changing society. The interface between the family-centered old age support system and emergent public policies to boost economic security and social services for the aged is also explored.