The framework of the International Classification of Functioning, Disability, and Health (ICF) was applied to examine the factors associated with childhood impairment and leisure activity. Information on leisure activity was obtained using a structured questionnaire from a population-based cohort of young adults with childhood impairment. The results underscore the differences in leisure lifestyles by impairment type and severity. Activity limitations, educational attainment, and the acquisition of adult social roles were significant predictors of leisure activity. This study emphasizes the importance of improving daily activities, increasing attendance of postsecondary school and opportunities for competitive employment and participation in impairment-related programs to help increase the number and scope of types of leisure activities for young adults with developmental disabilities. (Contains 5 tables and 2 figures.)