Purpose – Elder mistreatment is a neglected issue in the Macao elder policy. The purpose of this paper is to review the current elder policy as well as legislation on the prevention and management of elder mistreatment in Macao and providing practical suggestions to improve the situation. Design/methodology/approach – This paper reviews government documents and statistics on elder services and policy of Macao Special Administrative Region (MSAR) government. The authors interviewed frontline social workers for the phenomenon of elder mistreatment in Macao as well as the issues and problems in handling abuse cases. Findings – This paper argues that the MSAR government has paid attention to financial aid to its senior citizens. In terms of elder care services, the government outsources various elder care services to nonprofit organizations and other private bodies. However, this public-private partnership approach cannot adequately coordinate service providers to prevent and manage elder mistreatment. Furthermore, Macao-mainland integration has encouraged more and more elders to stay in mainland China. Stronger government initiatives are needed to collaborate with Macao society, as well as mainland authorities, regarding the mistreatment of Macao elders. Research limitations/implications – It is only a review on elder mistreatment in Macao. Further research is needed to survey the extent of mistreatment of elder people in Macao (quantitatively and qualitatively). Besides, more effort has to be paid on the problem and difficulty of frontline social workers handling elder mistreatment. Practical implications – This paper suggests practical methods and measures to Macao government to manage and prevent elder mistreatment which is a neglect issue in the society. Social implications – There are very few studies on elder mistreatment in Macao. This paper aims to draw the attention of Macao government and public as well as academic to the issue. Originality/value – Many scholars and academics studying Macao elders have been directing to the government focus and keep their eye on the pension system and social security for the elderly. Very limited studies have examined the elder care and mistreatment. This paper is a breakthrough of Macao elder studies that serving as a pilo