Long-term care is a world disproportionately comprised of women as consumers and as providers. Women comprise 75 percent of nursing home residents, 97 percent of professional caregivers, and the vast majority of family caregivers for elderly relatives at home. This article explores how and why long-term care, both in an institutional setting and home-based, is primarily utilized by women. The gender differences in the provision of care are also examined. The three key approaches to payment for long-term care (private payer, insurance, and Medicaid) are a focus with an emphasis on the role of Medicaid. Long-term care looms as an explosive issue and an accessible target for future program cutbacks. Since women are the predominant customers and providers of long-term care, this should be a priority issue for the feminist agenda.