BACKGROUND: As societies age, ensuring the quality of life of dependent individuals has become a pressing concern, affecting an increasing large segment of the population. Understanding whether dependent individuals receive the type of care they prefer is central to their well-being. However, there is limited evidence regarding the alignment between care preferences and the care arrangements received by dependent persons. This article aims to provide new insights into how individual and contextual factors are associated to the match -or mismatch- between care preferences and current care arrangements, as well as its implications for individuals' well-being and satisfaction with care. METHODS: We use data from the 2023 Survey of Older People with Functional Dependency, which includes a representative sample (n = 1,600, with 992 self-respondents) of dependent individuals aged 65 and over in Barcelona, Spain. Logistic regression models are used to estimate the associations between dependent individuals' characteristics and their care preferences, as well as the matching between these preferences and their current care arrangements. We further examine how this alignment relates to satisfaction and well-being. RESULTS: Care preferences differ based on sex, household size, level of dependency, and household income. Approximately 70 per cent of older dependents report that their current care arrangements do not match their care preferences. Older dependent women and those over 85 are less likely to have care arrangements aligned with their preferences. Living with others in the household increases the likelihood of alignment between preferences and care provision. While no significant association was found between alignment and well-being indicators, we observed that care match enhances individuals' satisfaction with care they receive. CONCLUSIONS: Older dependent individuals' preferences for care provision often do not match their current care arrangements. Both individual and contextual factors could explain this phenomenon. The widespread preference for receiving care at home highlights the need for social policies that promote home-based solutions. As family support for dependent individuals becomes less available, and given the significant burden this may place for family caregivers, there is a growing need to develop flexible, personalized, and sustainable care strategies.