This article examines gender inequalities in the fields of health and familial elder care in China. Based on interviews conducted from 1997 to 1999 with 110 familial caregivers who were taking care of their physically dependent parents, this study explores various aspects of gender differences in both generations of care recipients and caregivers. The variables studied include health status, health care benefits, and income disparities among care recipients as well as caregiving task performance, employment status, and income levels among caregivers. Findings suggest that elderly female care recipients were more likely to receive no pension and medical benefits than their male counterparts; and female caregivers were more likely to earn less income when employed. Meanwhile, female caregivers were performing more hours of care tasks per week and were more involved in personal care and house chores even though they perceived their health as being poorer compared with their male counterparts. Male caregivers were more likely to provide financial assistance to parents. As the economic reforms continue and future family size reduces to a 4-2-1 inverted pyramid, the author argues that gender inequalities are likely to perpetuate or even worsen. Current female caregivers are likely to suffer from greater disadvantages in terms of reductions in income, retirement benefits, and health benefits due to their greater involvement with elder care. In turn, they are not going to have several adult children to share care responsibilities when they become older and need help.