With the progressive aging of China's population, the contradiction between the supply and demand of elderly care service facilities is increasingly prominent. This study takes Wuxi City as the research area, and evaluates the accessibility characteristics of the elderly service facilities in Wuxi City by using geographic statistics, buffer analysis, Gaussian two-step mobile search and other methods. It then analyzes the spatial distribution and supply and demand of the elderly service facilities in Wuxi City, and introduces the XGBoost algorithm to calculate the factors influencing the distributions of different types of elderly services. The results show that the distribution of home-based and institutional endowment resources in Wuxi is spatially heterogeneous, but there are problems of mismatch between supply and demand and uncoordinated regional development. The accessibility of endowment services varies greatly in different regions, and the number of hierarchical endowment institutions is relatively small. The distribution of community home care service stations is relatively more equitable, but still does not match the size of the elderly population. There are obvious differences in the factors affecting the distributions of nursing institutions and community home nursing service stations. The distribution of nursing institutions is affected by transportation infrastructure, the size of the elderly population, the number of medical resources, the environment, economic level and other factors; while community home care is mainly affected by the size of the elderly population. In order to better meet the elderly service needs of residents, Wuxi needs to increase its investment in elderly service facilities and take various measures to promote the development and improvement of its elderly service facilities.