For the last quarter century, China has experienced unprecedented internal migration of rural labor, which has helped fuel its phenomenal economic growth. This lecture examines multigenerational families in rural China, focusing on older adults who remained in their home villages after their adult children moved away in search of employment. These so-called “left behind” elders are often caring for grandchildren left behind by their migrant parents. However, little is known about the consequences of this status for the well-being of rural elders. Drawing on a mutual-aid model of Chinese family functioning and a 14-year longitudinal study of aging in rural China, empirical models are presented that provide evidence of a mixed, but mostly positive, picture. Although older adults with migrant children appear to face a deficit of intergenerational support, they also tend to have better emotional, physical, and cognitive health than their counterparts. These advantages are largely, but not solely, related to selection processes signalling pre-existing robustness of child-care providers. Most notably, remittances positively contribute in important ways to the quality of life of rural elders. These findings are discussed in the context of rapid demographic change and public policy reforms in China over the last decade.