Self-initiated free play experiences are vital for the normal growth and development of all children. In this paper, children with physical disabilities who are deprived of normal play opportunities are viewed as having a second disability that hinders their potential for independent behavior and performance. Physical, social, personal, and environmental barriers that may limit the play experiences of children with physical disabilities are delineated. Studies of the interactions of these children during play are discussed, and a case is made for the promotion of active, free play in the home, the school, and the community. As facilitators of this process, occupational therapists must consider a variety of factors, including the unique capabilities of the child, the influence of parent–child and peer relationships, the role of other caregiving adults, the adaptation of toys and materials, and the impact of the environment and setting.