This systematic review examines the evidence for the effectiveness of interventions within the scope of occupational therapy that address leisure engagement and social participation among community-dwelling older adults. Eleven Level I, 1 Level II, 1 Level III, and 1 Level IV studies met inclusion criteria. Included articles addressed two themes: interventions supporting social participation and interventions supporting leisure engagement. Strong evidence supports leisure education interventions to enhance leisure engagement, and moderate evidence supports chronic disease self-management programs to support leisure engagement. Mixed evidence exists for community-based group interventions and electronic gaming to support social participation. Routine use of leisure education and chronic disease self-management programs to enhance leisure engagement and selective use of community-based groups and electronic gaming to support social participation are recommended.