In August and September of this year, the world will turn its attention to Rio de Janeiro, Brazil, for the 2016 Summer Olympic and Paralympic Games. Of interest to physiatrists, the Paralympic Games will take place from September 7 to 18, with an estimated total of 4 billion viewers. In the United States, for the first time in history, the Summer Games will be broadcast over a total of 66 hours on NBCUniversal. The Paralympic Games represent the pinnacle of elite sport for athletes with disabilities while also changing perceptions around the importance of grassroots sport and physical activity opportunities for the disability community more broadly. It is no secret that the planning and preparation forthe Rio Games has brought with it a number of challenges—the Zika virus, water quality, construction delays, and the oft-tenuous state of the Brazilian political system, to name a few. In some respects, these challenges are important as they stimulate discourse about the future of the Olympic and Paralympic Movement. In Paralympic sport, some of our current and most salient challenges are rooted in principles of sports medicine and science, as outlined herein. Because it is imperative to uphold the highest standards of athlete health and safety at the Games, this presents an unparalleled opportunity for the voice of physiatrists to come to the fore. As experts in disability and functional performance, neurologic and musculoskeletal rehabilitation, and sports medicine, we uniquely are suited to make an important and timely impact on Paralympic sport. Here, we provide a snapshot of what to watch out for in Rio.