The transformation of China’s elderly care system is a critical response to the country’s rapidly ageing population. The system has evolved from a traditional model based on family care and welfare support to a more industrialized and integrated framework. This shift is necessary to address the growing demand for diverse, high-quality care services, especially in rural areas. Despite progress, the system faces significant challenges, including fragmented service standards, a shortage of skilled professionals, limited social capital investment, and mismatches between supply and demand. This review discusses the strategic pathways required to overcome these obstacles, focusing on four key areas: (1) the development of a unified care-industry standards framework to improve service quality and efficiency; (2) the establishment of comprehensive talent development programs to address workforce shortages; (3) the integration of digital technologies to enhance service delivery and accessibility; and (4) the promotion of a collaborative governance model that includes the government, market, and society. These measures aim to align service supply with the evolving needs of the elderly, while fostering the growth of the silver economy. Looking ahead, the Chinese government’s policy objectives include the establishment of a nationwide elderly care service network by 2029 and the creation of a fully developed, high-quality system by 2035. This comprehensive approach seeks to ensure the sustainable growth of elderly care services, enhance the quality of life for elderly citizens, and contribute to addressing the challenges posed by global demographic change.