This paper addresses the issue of fairness in the layout of elderly care facilities, takes institutional elderly care facilities and community elderly care facilities as the research objects, uses the elderly population data, facility POI data and road network data, and uses service area analysis, spatial unit service level analysis, Gini coefficient and locational entropy analysis, and bivariate analysis to analyze the spatial service and social fairness of elderly care facilities in the main urban area of Tianjin, as well as the spatial correlation between them. The results show that①the spatial service of institutional elderly care facilities in each street is high, but unevenly distributed, while the spatial service of community elderly care facilities is low, but not widely distributed.②The overall social fairness of the institutional elderly care facilities is good and the difference in spatial distribution is small, while the overall social fairness of community elderly care facilities has a wide gap and a large difference in spatial distribution. ③ The spatial distribution pattern of spatial service and social fairness of elderly care facilities does not match. On this basis, relevant policy recommendations are put forward and the study on the fairness of the layout of elderly care facilities is prospected.