The governance principle of ‘small government, big market’ in Hong Kong determines the structure of its social welfare system. This neoliberal framework encounters substantial challenges from rapid population ageing, which has widened the gap between care demands and formal long-term care capacity. Informal carers assume a critical role in mitigating this care deficit, yet research on their experiences and psychological well-being remains limited. Hong Kong exemplifies how Western-influenced governance intersects with Confucian values of filial obligation and creates unique pressures on informal care that merit examination. This chapter first reviews the demographic characteristics of care recipients, namely older adults and people with disabilities, and the available formal and informal support structures. It then analyses data from the Labour and Welfare Bureau’s 2022 consultancy study to examine carers’ perceived roles, help-seeking behaviours, care intensity, assessments of formal support adequacy and psychological well-being. Findings reveal that carers invest considerable time and effort in care provision. Whilst carers believe the government should assume primary responsibility for care, they rely predominantly on informal networks when confronted with difficulties. The formal care system demonstrates critical limitations, including inadequate identification of high-risk carers and insufficient family-centred support. The chapter argues that a robust integration of informal and formal care systems is essential to establish a sustainable care framework that addresses Hong Kong’s evolving demographic challenges.