This review analyses the gender dimensions of rapid population ageing in the Asia-Pacific region, shares examples of useful practices and makes policy recommendations within the context of the 2030 Agenda for Sustainable Development and the Madrid International Plan of Action on Ageing. Population ageing is occurring at the same time as urbanization, migration, more women in paid work, smaller families, technological advances and environmental changes. Awareness of population ageing is increasing, with reports from international agencies and new national policies and plans. But these often fail to respond to the different needs of older women and men and to recognize and benefit from their different contributions. Age and sex discrimination intersect to disadvantage both women and men. Gender and ageing analysis need to be mainstreamed within development programmes. Women live longer than men yet have higher risk of poor health and disability in old age, suffering the accumulated effects of gender inequality throughout their lives. Although most older women and men continue to live with their families, older women are more likely than men to live alone, to be widowed and poor. They have had fewer opportunities to earn or make pension contributions and may lack inheritance rights. Older men are more likely to be socially isolated and miss their earlier roles. Older persons' community organizations reduce social isolation and have many benefits. Conditions affecting quality of life are more common in older women and often neglected, including sensory impairments, arthritis, incontinence, falls and sleep disorders. Risk factors also show gender differences. Women are less likely to be physically active; older men are more likely to drink alcohol and smoke. Older women face greater barriers to health care. Caring for dependent older family members is usually the responsibility of women, and paid care providers are disproportionately female. Family caregivers need support, help with assistive devices and respite care. They are often unable to earn and save for their own old age. Older persons groups could provide paid or voluntary care services at the community level. Government, civil society and the private sector all have roles in facilitating the contributions of older persons, preventing disability and providing care and support. National Governments need to invest in policies that recognize the different rights and roles of older women and men.