The elderly living alone in urban areas form the most difficult group in home care and those aged 70 and above are more difficult among them. Investigating 3363 elderly aged 70 and above and living alone in Chengdu, Dalian, Guangzhou, Hohhot and Shanghai, and collecting and analyzing data on their income security, medical security, service security, participation security, environment security and their needs, this paper finds out that there are diverse characteristics on the need for caring and the group that need targeted care most is explicit. Therefore, the government and the society should improve some policy suggestions on targeted care for the elderly living alone in urban areas on the supply side, including strengthening the notion of targeted care, precisely selecting focus groups of the elderly living alone, exactly determining different care measures for the elderly living alone with different demands, exactly establishing a all-weather and multifunctional system of emergency service call for the weak people of advanced age, effectively advancing institutional care for the elderly living alone and quickly establishing database on the elderly living alone in community.