Since 2011 China’s new nationwide system of neighborhood aged care has invited nonstate organizations to carry out aged care provision in urban residential communities. This article examines how this nationwide program has been variously implemented at local levels. Based on case studies in the cities of Shenyang, Suzhou, and Guangzhou, the article identifies three types of models for aged care: (1) state dominated, (2) partial outsourcing to commercial enterprises under direct state management, and (3) collaboration with autonomous nonprofit organizations. The three case studies highlight the varying degrees of autonomy that nonstate actors and organizations have acquired to carry out local progams which provide community services. A few important factors, including the local political economy, the supply and demand for government-purchased services, and socialist legacies, together contribute to various modes of neighborhood aged care. The findings reflect evolving state-society relations and demonstrate the flexibility and diversity of local governance in China.