Population ageing is a powerful and inevitable demographic phenomenon which is dramatically reshaping Asia, home to 60 per cent of the world’s population. Inside Asia, the East has the largest number of elderly people. The relatively younger South Asia is the second biggest home for Asia’s elderly after the East. However, South Asia has a far from proper elderly care policy, unlike the greying Western countries. It will also face ageing at a relatively initial stage of economic development. Hence, for South Asia, only early action can lessen the negative impact of population ageing. This chapter analyzes the demographic pattern and population ageing in South Asia in general and India in particular to underline the challenge. India, though not ageing yet, has the largest number of South Asia’s elderly. Its large and diverse population makes it complex to handle the ageing problem at the policy front. There is also a reluctance and even ignorance about understanding ageing policy formulation and its effective implementation for elderly care. Situational analysis of population ageing and comprehending the flaws in existing policy for Indian elderly can create a policy model for other South Asian countries, as they share close socio-cultural norms, such as family-centric elderly care. By focusing on the two major demographic challenges of ageing and elderly care policy, this chapter explores the ageing situation and existing elderly care policies in India and other South Asian countries and offers policy suggestions.