This article describes the development of the rehabilitation counseling profession in the United States. Early roles as a government agent providing simple vocational advice and guidance to individuals with physical injuries grew into a complex professional role. That role now demands knowledge of occupations, disability issues, psychological testing and evaluation, legal issues related to employment as well as personal counseling skills. Specialized university educational programs at the master's degree level now prepare individuals for this profession. While early employment tended to be exclusively with public and government agencies, current rehabilitation counselors work in a variety of public, community, and private rehabilitation agencies as well as in educational and school settings. While a uniquely American profession in development, the skills and training of this profession may have application to other cultures as well.