The Seoul Metropolitan Government, along with 18 central ministries including the Special City of Seoul, convened the "North Korean Defectors Protection and Settlement Support Council" to decide on transitioning North Korean defectors' policies toward a family-centered community approach. Based on this, the government announced the "4th Basic Plan for Supporting the Settlement of North Korean Defectors (2024–2026)" in May 2024, emphasizing the strengthening of policies considering the family. From the perspective of supporting vulnerable populations, the Seoul Metropolitan Government established the "Seoul Cooperation Plan for the Self-Reliance of North Korean Defectors," which, like previous government policies, focused on individual-level initiatives. However, with the government’s shift in policy direction, Seoul now faces the necessity of promoting family-oriented policy initiatives and identifying relevant projects. This study conducted, for the first time by any government or local authority, a household-based survey on the living conditions of North Korean defectors. The results revealed that 61.6% of North Korean defectors residing in Seoul are single-person households, nearly double the proportion (36.8%) of general Seoul citizens. Among North Korean defectors in Seoul, 62.0% of household heads capable of working are employed, 31.7 percentage points lower than the general Seoul citizen rate (93.7%). Additionally, the economically inactive population among North Korean defectors was 20.5%, nearly double that of general Seoul citizens (10.6%). The main reasons for economic inactivity among North Korean defectors were household responsibilities (25.3%) and physical or mental disabilities (21.7%), which differ from the reasons among general citizens, where old age (38.5%) and household duties (22.4%) are predominant. Over the past year, the average annual income of North Korean defector households in Seoul was 24.04 million KRW, significantly lower than the 73.69 million KRW of general Seoul citizens and the 36.13 million KRW of North Korean defectors nationwide. Despite showing relatively high life satisfaction, a vast majority (88.4%) of Seoul’s North Korean defectors perceived their household’s socio-economic status as being in the lower-middle range. This highlights significant socio-economic vulnerability among North Korean defectors in both subjective and objective terms. Additionally, 34.3% of North Korean defector households in Seoul reported having a family member with a chronic illness, about six times higher than the rate among general Seoul citizens (6.1%). Notably, among the types of chronic illnesses experienced by household members, "depression" accounted for the highest proportion at 36.5%. Regarding emotions felt over the past week, 57.2% of respondents reported feeling sad or negative emotions, a much higher rate than the 35.4% reported by general Seoul citizens. Alarmingly, 10.6% of North Korean defectors in Seoul reported contemplating suicide, about three times higher than the 3.4% among general Seoul citizens. Given the differences in family types and member characteristics, Seoul must pursue a balanced policy approach and identify projects that emphasize both family and individual needs. The stable settlement and self-reliance of North Korean defectors can only be achieved through a combination of individual and family-centered support. Based on the findings of the living conditions survey and expert focus group interviews, Seoul’s policy direction for North Korean defectors should focus on four dimensions: Preventing family breakdown, promoting family reunification, and supporting the formation of healthy families. Enhancing physical and mental health support for vulnerable and at-risk households. Preventing isolation of single-person households and fostering social networks. Providing high-quality job opportunities and supporting work-life balance for economic independence.