Data from the Manitoba Longitudinal Study on Aging is used to describe the 1975-78 home care utilization of a large probability sample of elderly interviewed in 1971. The predictors of home care use of these interviewees are identified by multiple logistic regression analysis. Findings indicate that a home care program based solely on professionally assessed need admits only a small minority of elderly and that, next to age, difficulty in coping with the instrumental activities of daily living is one of the best predictors of subsequent home care use. Differences between the determinants of home care and long-term institutional care are noted and the policy implications of the findings are discussed.