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In the past decade, governments and civil societies across Europe have designated exclusion from social relationships in later life as a priority for intervention. Many solutions have been proposed, some of which have been implemented and most of which have not been evaluated. This means that, to date, it is unclear how best to tackle the issue. In this article, we seek to reduce this uncertainty by reporting on patterns of loneliness in the English longitudinal study of ageing (Elsa) begun in 2002, and deriving implications for intervention. What the data from the 15,783 participants who took part in at least one of Elsa’s first six waves show is that: self-reports of loneliness fluctuate significantly over time; certain subgroups of older adults are particularly at risk of repeatedly feeling excluded from social relationships; and, while loneliness and social isolation are correlated, there is limited overlap between the two. These findings raise a number of challenges for policy responses, but also hint at potentially promising opportunities for future prevention strategies.