Ensuring students with severe disabilities access the rich relationship and learning opportunities available within general education classrooms is an important—but challenging—endeavor. Although one-to-one paraprofessionals often accompany students in inclusive classrooms and provide extensive assistance, the constant presence of an adult can inadvertently limit the social interactions and engagement of adolescents with severe disabilities within high school classrooms. This article describes peer support arrangements as a practical and promising alternative to an exclusive reliance on paraprofessional-delivered support. We draw upon our recent partnership with schools implementing these interventions for more than 50 high school students with severe disabilities and involving more than 100 peers without developmental disabilities. This article outlines practical steps for establishing these interventions in inclusive classrooms.