It is estimated that 3.2% of Cuba’s population of 11.4 million persons has a severe disability of some kind. Recent economic difficulties have, it may be assumed, had a negative impact on health service provision – which is free to all – and thus, on population health outcomes and nutritional levels. There is a traditional culture of family care for children and adults with intellectual disabilities (IDs), although it is apparent that unfounded beliefs about the etiology of disabling conditions as well as social stigma persist. The Constitution indicates that it is necessary to provide education for children with intellectual and other disabilities in primary schools, while other ministerial resolutions create special schools. ID is construed chiefly as a social problem. Children with IDs are the responsibility of the Minister of Education; it is possible that children with severe levels of disability may not attend school and rely on family support. For adults, rehabilitation includes physiotherapy and other services such as “defectology”; strategies for adults who are evaluated include both segregated and institutional elements. The author suggests that two key issues are related to policy and practice in Cuba. One is the minimal content on special education in teacher preparation programs, and the other, that despite a cultural tradition of family care, family involvement in special education, or in rehabilitative services, remains limited.