This chapter addresses the critical need for inclusive STEM (Science, Technology, Engineering, and Mathematics) education for students with intellectual disability and extensive support needs (ID/ESN). It emphasizes the importance of providing high-quality, grade-aligned academic instruction to enhance the quality of life for these students. Despite federal mandates, many students with ID/ESN lack access to comprehensive STEM education, often only receiving foundational skills. This chapter reviews evidence-based practices and instructional frameworks, such as schema-based instruction and the STEM Instructional Framework, designed to make STEM content accessible and meaningful. The chapter highlights the benefits of teaching processes for answering questions and solving problems, fostering self-determination, and promoting critical thinking and problem-solving skills. It also underscores the necessity of integrated STEM approaches to provide equitable educational opportunities, enabling students with ID/ESN to engage fully with interdisciplinary STEM fields and prepare for future educational and career opportunities. By utilizing evidence-based practices and structured routines, educators can support students with ID/ESN in developing the knowledge, skills, and dispositions needed to navigate and understand the world around them.