The aging and elderly care in Pakistan is highlighted in the chapter. Pakistan is a country considered the seventh most populous country in the world with an estimated population of 220 million people in 2017. In 2013, Pakistan signed a MoU with China for 56 billion in US$ to create opportunities for the youngsters, but there was no story of opportunity included for the senior citizens. Thus, the question remains what will be the outcome for Pakistani seniors? An attempt has been made to raise awareness of the plight of seniors to the Pakistan Government's attention; however, since there is no formal policy dedicated to elders from the Chinese mega MoU and political instability, only little has been accomplished to better the lives of older adults. Modernization has had a major impact on the life of older Pakistani, and not always a positive effect. Increases found in elders’ psychological problems are likely correlated with modernization. This research focuses on the important issues that are making the lives of senior citizens more difficult. The issues include psychological factors, anxiety, physical issues and environmental issues.