As the challenges posed by an aging population to society, the economy, and public health systems become increasingly severe, the rational and equitable allocation of elderly care resources becomes particularly crucial. This study utilizes a variety of methods including projection pursuit models, kernel density estimation, spatial autocorrelation analysis, and the decomposition of the Gini coefficient to analyze provincial panel data of urban and rural elderly care institutions in China from 2008 to 2021. The aim is to explore the equity of the spatial distribution of elderly care institution resources and their dynamic changes over time. This research seeks to assess and improve the accessibility and equity of elderly care resources. The results indicate that the degree of population aging in China has significantly intensified, with urban elderly care institutions’ resource allocation increasing annually and surpassing that of rural institutions. However, inequalities in the allocation of elderly care resources between urban and rural areas, as well as among different regions, still exist. The instability in the allocation of resources in rural elderly care institutions, the overall improvement in urban elderly care resource allocation, and the spatial agglomeration of elderly care resource allocation are the main characteristics. Based on these findings, the study proposes a series of policy recommendations aimed at addressing the inequalities and instabilities in the allocation of urban and rural elderly care resources.