Disability is a socially constructed identity. What constitutes a disability and what it means to be a person with a disability can vary across cultures. This article explores meanings of disability within Native American cultures, including how ideas about wellness, balance, roles, and responsibilities influence perceptions of disabilities. This is followed by a review of disability prevalence, discussion of services, and explorations of possible reasons for the disproportionate impact of disabilities in Native American populations. The article concludes with an examination of how the colonial context frames both attitudes about and services for Native Americans with disabilities.