Occupational therapists exploring international opportunities should understand how the profession is practiced globally. This paper describes the framework under which occupational therapy services can be accessed by families of children with disabilities in urban India. Background information about the country, its health care, and occupational therapy education and practice is presented in brief. To provide the context for school-based services, government and private initiatives addressing general education and special education are described. Currently few therapists are working in schools. Insights regarding facilitating the expansion of occupational therapy in early intervention and schools in India and other countries are presented.