Vietnam is experiencing rapid population aging, creating rising demand for long-term care while traditional family-based care is increasingly constrained by urbanization, migration, and smaller household sizes. This chapter examines Vietnam’s evolving LTC landscape through a public–private lens, synthesizing demographic and socioeconomic trends, the current configuration of public support and social assistance, and the emerging private market for LTC services and insurance. Drawing on recent evidence and policy developments through 2024, the chapter highlights three structural gaps: (i) the absence of a dedicated national LTC insurance scheme, resulting in fragmented entitlements and uneven access; (ii) persistent constraints in financing, infrastructure, and workforce capacity, especially in rural and underserved areas; and (iii) limited affordability, low public awareness, and regulatory weaknesses that hinder the scale and credibility of private LTC provision. The analysis argues that Vietnam’s transition from a piecemeal approach to a sustainable LTC system requires coordinated reforms, including the establishment of a comprehensive public LTC insurance framework, targeted investment in geriatric and community-based service infrastructure, standardized training and certification for caregivers, and stronger regulation to protect consumers and support responsible market development. The chapter also discusses the potential of public–private partnerships and prevention-oriented strategies to improve equity, contain costs, and enhance care quality as demographic pressures intensify. Together, these findings provide policy-relevant insights for designing an integrated, financially sustainable LTC system that safeguards the dignity and well-being of Vietnam’s aging population.