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A growing group of migrants to the U.S. and other Pacific Rim countries hail from small islands settled by sojourners from Asia two centuries ago. In this multicultural and developing region, beliefs about disability, perceptions of disabilities, and local treatments for disability have similarities and differences. Two hundred essays by adults from the U.S. affiliated Pacific Islands about perceptions of disability in their cultures were analyzed using grounded theory. Results included regional differences, ideas about supernatural and spiritual causes of disability, and attitudes toward intervention. Apparent conflicts between compassion for and rejection of people with disabilities are discussed. Teachers and health providers need to be aware of the cultural contexts of peoples’ beliefs in order to effectively work with them.