Importance: Work and industry (W&I) is a vital yet underrepresented area of occupational therapy practice. Describing the current practice trends, challenges, and opportunities in W&I provides a foundation for future development and advancements.

Objective: To describe the state of W&I occupational therapy practice and to identify challenges and opportunities in this specialty practice area.

Design: Cross-sectional survey conducted June 12 to July 17, 2020.

Setting: Online survey distributed through direct email invitations and online platforms (i.e., CommunOT, LinkedIn).

Participants: One hundred twenty occupational therapy practitioners who had worked in W&I within the most recent 5 yr.

Outcomes and Measures: We used 30 multiple-choice, Likert-scale, and free-response questions across three topics: (1) training, resources, and research; (2) challenges and barriers; and (3) opportunities.

Results: Most respondents were occupational therapy practitioners working in clinical settings with >5 yr of experience; 29.2% identified as male. The most frequently provided services were ergonomic consultation and worksite evaluation; clinic-based W&I services were less frequently provided. Workplace injury prevention, management of psychosocial issues, and employee wellness programs were ranked as the top opportunities for occupational therapy in W&I. A shortage of accessible training and resources to support W&I practice was found, particularly mentoring and occupational therapy–focused research evidence. Maintaining referrals, competition from other professions, and limited support from professional organizations were key challenges.

Conclusions and Relevance: This study illustrates the evolution of W&I occupational therapy practice and highlights an urgent need for increased professional recognition and educational support to maintain occupational therapy’s presence in this practice area.

Plain-Language Summary: In this study, we describe the current practice trends in work and industry occupational therapy practice. We identify challenges related to resources and training in this practice area and provide insights into opportunities for future development. The study findings show the evolution of work and industry occupational therapy practice and highlight an urgent need for more professional recognition and educational support to maintain occupational therapy’s presence in this practice area.

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