This study investigated the evidence base for health promotion interventions targeting social isolation and loneliness in older people. The research comprised: a systematic literature review, a survey of projects in northern England, and case studies involving interviews with staff and older people. The majority of projects were not evidence based with large variations in evaluation. The review identified a small number of relevant studies. Effective interventions targeted older people at risk and enabled participants some control over project activities. Older people differentiated between chronic and situational loneliness, and isolation versus loneliness, suggesting a need for different interventions. Many projects did not have strategies for identifying isolated, lonely older people. Access to activities intended to alleviate social isolation and loneliness among older people was often inequitable, tailored to participants'' expectations, rather than to the needs of those most isolated and lonely. Many projects consulted older people superficially, providing activities, which did not necessarily meet the needs of isolated, lonely older people.