Ratios and proportions are foundational to student understanding across multiple topics in mathematics and science. In mathematics, they are central to developing concepts and skills related to slope, constant rate of change, and similar figures, which are all fundamental to algebraic concepts and skills. This article examines the importance of ratio and proportions to the development of comprehensive algebra readiness skills for students with mathematics disabilities and difficulties. [This paper was published in "Teaching Exceptional Children" (EJ1129390).]