As occupational therapists increasingly encounter a multicultural clientele, there is growing interest in the influence of a person’s culture on his or her interactions with the environment. This paper presents a case study of a Chinese-Canadian immigrant woman with rheumatoid arthritis. The case study illustrates how the subject’s family, community networks, and workplace, coupled with the occupational therapy clinical setting, intermingled to shape the daily management of her illness. The case material focuses on the subject’s acquisition and use of different types of health care knowledge as she responds to her illness. It shows that the subject’s experiences and management decisions about her health are closely linked to the material and social conditions of her life as a working-class immigrant woman. This article suggests that attention needs to be paid to the broader systems of the environment in understanding the responses of immigrant women to occupational therapy, rather than on the cultural distinctiveness of the clients.