This chapter takes a critical look at disability inclusion, rights, and policy in Latin America by placing grassroots movements, Indigenous knowledge systems, and the lived experiences of disabled communities at the center. It challenges Western, rights-based, and institutional models that are dominant and argues that top-down approaches based on universalism, individualism, and legalism often do not manage to cope with the region’s historically situated realities, which were shaped by colonialism, racial capitalism, forced assimilation, and political violence. Although international frameworks, such as the Convention on the Rights of Persons with Disabilities (CRPD), have expanded the scope of formal legal recognition, there remains a significant gap between rights on paper and justice in practice. By using decolonial disability studies, the chapter shows that disability is both produced and experienced relationally–it is closely tied to land dispossession, poverty, gendered violence, environmental injustice, and Indigenous marginalization. Grassroots and community-led movements are seen as central sites of policy knowledge, able to express alternative visions of inclusion grounded in relationality, reciprocity, collective care, and belonging rather than autonomy and productivity. The chapter is examining the issues of Indigenous self-governance, legal pluralism, participatory praxis, and pluriversal policy frameworks, and it is pointing out the existence of pathways toward disability justice that resist assimilation and co-optation. It also discusses ethical tensions such as the internal exclusions within movements and the risks of tokenistic state recognition. Finally, the chapter urges a shift from institutional access to lived justice–one that places self-determination, community-defined priorities, and South–South dialogues at the center. This chapter focuses on the bottom-up approach to envisioning inclusion in the first place, thereby playing a role in the formation of disability policies that are in tune with the culture, adapted to the place, and able to bring transformation in Latin America.