China’s rural areas exhibit a significantly higher aging rate than urban regions, yet face severe shortages in elderly care services. The application of artificial intelligence (AI) technology offers new pathways to address critical challenges such as resource scarcity and delayed service responsiveness in rural elderly care. This study explores the mechanisms through which AI enables high-quality provision of rural home-based care services, focusing on four dimensions: (1) AI-powered smart life assistants enhancing precision in daily care; (2) wearable devices enabling timely auxiliary healthcare monitoring; ( 3) intelligent terminals providing round-the-clock emotional companionship; and (4) smart elderly care platforms reducing cost burdens. Key barriers are analyzed through the lenses of: (1) limitations of age-friendly technology hindering smart assistant effectiveness; ( 2) financial constraints preventing wearable device adoption; ( 3) insufficient professional guidance lowering utility of intelligent terminals; and (4) lagging digital infrastructure constraining platform effectiveness. Accordingly, the paper proposes recommendations including enhancing R&D support policies to comprehensively improve the senior-friendliness of smart assistants, implementing income-boosting and subsidy policies to make wearable devices affordable to the general public, focusing on talent cultivation and recruitment policies to strengthen guidance and increase smart terminal utilization, and prioritizing digital infrastructure development policies to unlock the full potential of smart eldercare platforms. These measures aim to maximize the dual synergy between public policy effectiveness and the empowering effect of AI in optimizing the supply of rural elderly care services.