This study explores explanations for Chinese elders’ willingness or lack of willingness to use institutional care. The data is drawn from a survey over intergenerational relationships and age models conducted in Zhenjiang, China, in 2007. Only the responses of interviewees aged 55 and above (310 males and 318 females) were used in this study. Using zero-order correlation and multi-nominal regression analyses, this study examined the factors associated with Chinese elders’ willingness to use institutional care. Study results reveal that Chinese elders’ confidence in availability of familial care was negatively related to their willingness to use institutional care; elders’ knowledge about and impression on elder care homes were positively associated with their willingness. Male interviewees expressed lower levels of willingness compared to female respondents. This study shows that increased knowledge about elder care institution may increase Chinese elders’ willingness to accept institutional elder care.