Abstract: Purpose/Significance China’s aging population is increasing, and the supply of elderly care services cannot be separated from the leading role of the government. Clarifying the impact of fiscal decentralization and government preferences on the supply of rural elderly care services is the key to accelerating agricultural and rural modernization and comprehensively promoting rural revitalization. Design/Methodology Through the combination of theoretical and empirical analysis, from the three dimensions of income decentralization, expenditure decentralization and comprehensive fiscal decentralization indicators, the rural elderly care problem is combined with government behavior, and the impact and mechanism of fiscal decentralization and local government preference on the supply of rural elderly care services are investigated. Conclusions/Findings Fiscal decentralization has a restraining effect on the supply of rural pension services, while local government’s preference for welfare fiscal expenditure has a promoting effect, and the central government can significantly enhance this promoting effect through transfer payment. The central government should adjust the structure of fiscal decentralization by means of deconstructing administrative power, decentralizing financial power, increasing local fiscal revenue, and setting up special transfer payment funds for elderly care services, so as to promote local governments to improve the supply of rural elderly care services.