Today, society is seeing and hearing about individuals with significant disabilities working in their local communities. For many individuals with disabilities, this goal has been achieved with a vocational rehabilitation service option called supported employment and its extension called customized employment. This chapter presents the definitions of both supported employment and customized employment as characterized by Workforce Innovation and Opportunity Act. The chapter presents two models: supported employment, which is an evidence-based practice backed by decades of empirical research; and customized employment, a promising practice gaining more momentum as a viable vocational service option. Both offer opportunities for real jobs for real pay for individuals with severe disabilities. Despite the empirical evidence for these models and against segregated services, we have far to go before real work for real pay is an option for the majority of individuals with severe disabilities.