The rapidly ageing population and increasing emigration have intensified the demand for social care services, challenging traditional family-based care models in Hong Kong. In primary healthcare, community engagement and empowerment are essential in promoting preventive healthcare. Community engagement can address diverse health needs, build trust, and assure equitable access to services. Empowering local communities can identify the social and health issues and challenges, as well as increase community participation. In 2022, the Hong Kong Government launched the Primary Healthcare Blueprint for the sustainable development of primary healthcare in Hong Kong. Additionally, district health centres were established to enhance medical-social collaboration and public–private partnerships, focusing on holistic care and chronic disease management. However, low community engagement and inadequate needs assessment has limited the effectiveness of primary healthcare and district health centres. Despite the government’s efforts to promote primary healthcare, public participation remains low, threatening the sustainability of the healthcare system. This chapter provides a review of community engagement and empowerment in primary health and social care in Hong Kong. Recommendations to foster a sustainable primary healthcare system are proposed in three main areas: policy recommendations, industrial collaboration, and individual empowerment.