For many aging people, living alone leads to many positive and negative implications for their well-being. In Chinese culture, in which strong family ties and values are emphasized, elderly Chinese living alone is not a common phenomenon. This study examined the differences between elderly Chinese-Canadian immigrants living alone and those living with others, and the role of living alone in their health and well-being. The findings showed that those living alone reported fewer limitations in instrumental activities of daily living and received a higher level of social support than those living with others. Women living alone were less mentally healthy than their counterparts. Policies makers and practitioners need to address the mental health needs of the elderly immigrant women in this vulnerable group. Programs and interventions should address the gender and racial oppression, and culturally unique needs for stronger family support. © 2008, Hallym Aging Research Institute, Hallym University.