The purpose of the present study was to investigate practices that support the inclusion of students with severe disabilities in the learning and social activities of inclusive K-8 schools to inform inclusive school reform research and practice. Eighteen K-8 students with severe disabilities in six schools recognized for their implementation of inclusive practices were observed in a variety of school settings and activities. An appreciative inquiry lens was applied to these observations. The observation records were descriptively analyzed and organized around seven themes related to the practices used by the schools to support students with severe disabilities: (a) the teaching arrangement (who was providing instruction), (b) the type of engagement the student demonstrated during the activity, (c) the types of general classroom supports that were available during the observations, (d) the types of student supports that were provided to the student during the observation, (e) the type of work or activity the student was performing, (f) the interactions the student had with others, and (g) the choices provided the student. Findings provide information on the implementation of inclusive education for students with severe disabilities by reflecting contemporary best practices for inclusive education as well as identifying areas of need.