Return to work (RTW) following a traumatic brain injury (TBI) represents a pinnacle achievement for both the injured individual and those professionals working with the individual. The General Accounting Office (GAO) of the United States reviewed differences in RTW strategies comparing the United States to Germany and Sweden. Vocation serves a tremendously important role in life, yet vocational rehabilitation (VR) is one of the least understood and least delivered services for people with TBI. This chapter addresses the provision of VR services to individuals with TBI. People with brain injury who did not return to work had either been unable to sustain employment or were unable to return to work at all. Preinjury employment status and educational level have been demonstrated to be strong predictors of RTW. Individuals with TBI may not be familiar with VR services and vice versa. The International Classification of Functioning, Disability, and Health (ICF) provides a helpful framework and terminology for RTW planning and interventions.