This chapter describes the implementation of the the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) in special needs education (SNE) in Japan. It provides an overview of the status of education for students with disabilities and the use of ICF/ICF-CY in Japan. The chapter provides a description of findings of a survey of Japanese teachers on their perspectives about the ICF and ICF-CY in special needs education. It explores some illustrations of the use ICF/ICF-CY for SNE practice and application of an ICF-CY core set of codes and a digital tool for SNE settings in Japan. The chapter disusses the challenge: the use of ICF-CY in consideration of reasonable accommodations. In Japan, students with disabilities are provided educational services under al SNE. In SNE, consideration for the individual educational needs of the students, forms the basis of the efforts to fully develop their capabilities, their independence and social participation.