In this article, the authors discuss the hidden epidemic in higher education. They describe the stigma of chronic illness and argue that the invisibility of chronic illness may elicit particularly problematic responses from others, especially when faculty work in a context where people are expected to be highly productive and have unlimited intellectual energy. Looking fine on the outside but nevertheless experiencing real symptoms can put faculty members with illnesses in a challenging predicament when it comes to disclosing their conditions to colleagues, students, administrators, and others. The balance of costs and benefits shifts with each level of disclosure; department chairs, colleagues, and students require different decisions. Institutions have an obligation to examine their expectations for success and consider whether current assumptions about both physical health and scholarly productivity are reasonable. Both faculty and administrators need to recognize the predicament faculty members may face when seeking accommodation for a disability. For a person with an intermittent or progressive disability, challenges include whether and to whom to disclose the condition and how much about the condition to disclose, how to assemble resources, and how to navigate career expectations.