This paper presents the findings of a qualitative case study of the quality of life of three women with developmental disabilities. In-depth interview data were collected from the women who had previously worked in a sheltered workshop environment and were, at the time of study, working in supported employment in the community. Interviews were also conducted with each woman’s job coach and a family member or close friend. On-site observations of the women in their supported employment environments were also undertaken. Results show that the women’s own perceptions about their quality of life were not always as family members and job coaches expected, and that the purported benefits of supported employment for the three women with developmental disabilities were not always realized. Occupational therapists have an opportunity to facilitate the occupational performance of adults with developmental disabilities but they must be willing to engage in wider health and social policy change if they are to make significant gains.