To accurately grasp the current status of the equalization construction of elderly care services in the Yangtze River Economic Belt and ensure the coordinated development of regional elderly care services, this study constructs an evaluation index system for the equalization construction of elderly care services. Using the latest panel data from 11 provinces and cities in the Yangtze River Economic Belt as samples, the entropy method and Theil index are employed to evaluate the level of equalization construction of elderly care services in the Yangtze River Economic Belt. Additionally, the σ convergence, absolute β convergence, and conditional β convergence models are empirically tested for their convergence effects. The research findings show that during the sample period, the gap in equalization construction of elderly care services in the Yangtze River Economic Belt has gradually narrowed, and regional differences are smaller than intra-regional differences. There is a significant σ convergence feature in the equalization construction of elderly care services between upstream and downstream areas of the Yangtze River Economic Belt, with the downstream areas showing the highest level of absolute β convergence. Moreover, under the above model, there is a “catch-up” effect of upstream and downstream regions over midstream regions. The conditional β convergence of different driving factors varies: the population aged 65 and above significantly promotes conditional β convergence of equalization construction of elderly care services in upstream and downstream areas of the Yangtze River Economic Belt, the number of healthcare institutions significantly promotes conditional β convergence in midstream areas, and the expenditure of basic old-age insurance funds for urban and rural residents significantly promotes conditional β convergence of overall and regional equalization construction of elderly care services in the Yangtze River Economic Belt. The empirical analysis conclusions provide important policy insights for addressing population aging and improving the level of equalization construction of elderly care services.