This systematic literature review is an exploration of issues for adoptive families throughout the adoption process and into the various phases of the life of the adoptive family. Although there has been much recent research related to adoption, in general, very little adoption literature addresses the often unspoken needs of families who want to adopt or have adopted children with disabilities. These families report lack of good preparation services, post-adoption support, disability specific support, educational support and assistance with managing open adoptions. Children with significant emotional, physical, sensory or mental impairments represent an increased proportion of the population of children who have been adopted. This review of literature related to adoption and disability raises awareness of those involved in adoption processes and in education, of the needs of adoptive parents, which, in turn, will impact on the well-being of families, and waiting and adopted children with disabilities.