Neighborhood characteristics are relevant to understanding occupations and associated outcomes, yet few empirical studies have focused on neighborhood as the unit of analysis when examining person-environment-occupation relationships. The purpose of this report is to begin addressing that gap. We present findings from a qualitative investigation conducted as part of a larger mixed methods study of 100 African-Americans aged 55 and older living in a variety of neighborhood contexts. With a subsample of older adults (n = 20), we utilized participant-generated photos and photo-elicitation interviews to examine the question of how participation in everyday occupations changes (or not) for older African-Americans residing in urban neighborhoods that have undergone significant physical and socio-demographic changes. Data were analyzed using a thematic analysis approach in combination with a constant comparative method. Occupational change was conceptualized as four primary types: (a) spatio-temporal changes to participation in occupation, (b) changes to social participation, (c) heightened vigilance during daily occupations, and (d) actions to preserve and protect the neighborhood. The findings provide insights about the ways that neighborhood deterioration is related to occupational change. We discuss the potential impact of participants' occupational changes on health and well-being, and we assess the issue of neighborhood and occupation as relevant to occupational justice in urban contexts.