The demand for care and support in old age is growing nationally, but London faces some particular challenges. For example, although there are fewer older people in inner London, many are likely to need social care as a result of poor health, poverty, poor housing and lack of social support. This paper shows how London differs from the rest of England, examining past, present and future trends in its population profile, and in the resources and services available for older people. It casts light on some controversial issues such as levels of expenditure on residential and home care services, and finding care home places for older people outside the London area.