In any complex human society, distinct persons may have strikingly different standards of living. Those who lead the most undesirable, poorest lives in society can be called the worst off. Given that we almost always do not want to be, but some have to be, the worst off, we may want to find a right way to treat the worst off. In the West, John Rawls has proposed a conception of justice as fairness, and in the East, Confucius and Mencius have developed conceptions of ren (humaneness) and yi (righteousness) partly in order to deal with social injustice in the distribution of benefits and the problem of the worst off. Their conceptions and proposed solutions provide valuable ideas, which through comparison may be better assessed and then employed, or even combined, to address the problem. In this essay, I try to examine and compare their conceptions of distributive justice and the worst off, and then expound their suggested solutions to the problem and propose a provisional answer on the basis of those ideas.