The queen, who turns 96 on Thursday and has suffered what have widely been described as mobility problems, did not make her usual appearance at St George's Chapel in the grounds of Windsor Castle.
Prince William and Kate, the Duke and Duchess of Cambridge, walked to the chapel with their two eldest children Prince George and Princess Charlotte.
Behind them were the queen's youngest son Prince Edward and his wife Sophie, Countess of Wessex, with their children Lady Louise Windsor and James, Viscount Severn.
Princess Eugenie walked alongside Peter Phillips and his children Savannah and Isla, while Zara and Mike Tindall brought their eldest daughter Mia.
Heir to the throne Prince Charles and his wife Camilla, who represented the queen at a Maundy Thursday service at the same chapel, did not attend.
Meanwhile, Prince William's brother Harry and his wife Meghan, the Duke and Duchess of Sussex, spent Sunday morning at an athletics track for the Invictus Games in the Netherlands.
The couple, who quit royal duties and moved to America in 2020, were widely reported to have stopped in Britain to see the queen and Prince Charles on their way to The Hague.
The monarch marked 70 years on the throne in February but has been mainly been carrying out duties virtually in recent months and has missed a number of prominent events.
After spending a night in hospital in October, she spent the next three months under doctors’ orders conducting only light duties and contracted the coronavirus in February.
She did attend a memorial service at Westminster Abbey for her husband Prince Philip, who died aged 99 last year. Platinum jubilee events to mark the queen's service are planned for June.