The importance of exercise and physical activity has been well documented. Despite a relatively large number of children and adolescents living with disability, physical activity and sports activity participation is lower in children with disabilities. Risk for obesity is higher in children with disability. There are a variety of factors that affect participation in physical activity and/or sports. Some of these factors include physical, social, and environmental barriers; lack of access to resources; and parental views and support. Participation levels also vary depending on the type of disease process. In order to get children with disabilities more involved in physical activity, there are a few studies demonstrating the benefits of exercise or community exercise and strengthening programs. Similarly, there are a variety of sports and physical activity programs that children can get involved with. As a healthcare practitioner, it is essential to be aware of medical factors, injury risk, and available resources to assist with an individualized program for the child with a disability so the child can improve his/her overall physical and social wellbeing. This review manuscript aims to provide an overview of some of the issues affecting physical activity participation in children with disability and some of the special considerations in getting children involved.