Objective: A limited understanding exists of the relationship between disability and older persons' living arrangements in low and middle-income countries (LMICs). We examine the associations between living arrangements, disability, and gender for individuals older than 50 years in rural South Africa. Method: Using the Study on global AGEing and adult health (SAGE) survey and Agincourt Health and socio-Demographic Surveillance System (HDSS) data, we explore older persons' self-reported disability by living arrangements and gender, paying particular attention to various multigenerational arrangements. Results: Controlling for past disability status, a significant relationship between living arrangements and current disability remains, but is moderated by gender. Older persons in households where they may be more "productive" report higher levels of disability; there are fewer differences in women's than men's reported disability levels across living arrangement categories. Discussion: This study underscores the need to examine living arrangements and disability through a gendered lens, with particular attention to heterogeneity among multigenerational living arrangements. Some living arrangements may take a greater toll on older persons than others. Important policy implications for South Africa and other LMICs emerge among vibrant debates about the role of social welfare programs in improving the health of older individuals.