Women are more likely to live alone compared with men, and therefore have more difficulty activating emergency medical systems for stroke. The goal of this study was to examine the benefit of wearing medical alert devices to activate emergency medical systems for elderly women living alone. This was a randomized, controlled pilot trial. Women over 60 with at least 1 stroke risk factor were recruited from Southeast Michigan. Subjects received either a medical alert device or control. The primary outcome was change in health-related quality of life (HRQOL) from baseline to 90 days of wearing the device or control. A planned sample size of 320 could not be reached, and the trial was stopped at 265 women randomized prior to data examination. On average, the treatment group was older, reported lower prevalence of high cholesterol, and was less likely to complete follow-up. There was a nonsignificant smaller loss of healthy days in the past month in the intervention group (0.46) compared with the control group (2.23) (p = 0.213). Similarly, the secondary outcomes of changes in anxiety, depression, and changes in perceived isolation did not differ by treatment and control groups. This study did not establish improvement in HRQOL among women who wore the device compared with those that did not, nor the feasibility of a trial to study the efficacy of medical alert devices in elderly women. Newer devices that use cellular technology may be more accepted than the landline-based system used in this study.