Purpose: In this article, we examined how individuals with co-occurring psychiatric disabilities and substance use disorders encounter numerous challenges when it comes to the vocational rehabilitation (VR) process. Method: A comprehensive review of the literature demonstrated barriers to service delivery (e.g., access to services, exclusionary eligibility requirements) and hindrances to VR planning (e.g., lack of training of VR counselors, lack of work-related skills) which all serve to create obstacles through which they must navigate. This article provides a brief overview of (a) the challenges that these individuals face in treatment and VR and (b) general considerations for providing more recovery-oriented VR services to increase their participation in the VR process, facilitate recovery, and improve VR outcomes. Results: Our review highlighted that VR participation and successful outcome rates among this group as a whole are much lower than the rates of those with other types of disabilities. Researchers have suggested a myriad of strategies that have proven advantageous when working with these individuals all of which serve to increase rates of sustained recovery and employment success. Conclusion: Additional research is still needed to substantiate the barriers to service delivery for this underserved VR population, evaluate how to implement more recovery-oriented practices within the VR system, and determine if such changes do indeed lead to improved outcomes for consumers with co-occurring disabilities.