Introduction: Stroke is a leading cause of death and impairment in Colombia. There is unequal access to occupational therapy for stroke survivors and few data on services provided by occupational therapists. The study explored the experiences of Colombian occupational therapists working in stroke rehabilitation. Method: A total of 11 occupational therapists involved in the stroke rehabilitation in Colombia took part in two focus groups. Responses were analysed using thematic analysis within a critical realist theoretical framework. Findings: Three main themes were identified. First, participants discussed the ‘occupational therapy service’, highlighting changes since the 1970s, examples of contemporary good practice, and a range of barriers. Second, ‘attitudes’ included the impact of other professions views of occupational therapy and also the effects of low pay. Third, ‘action/way forward’ involved proposals for improving the current situation. Conclusion: Occupational therapists engaged in stroke rehabilitation in Colombia report a number of barriers. However, some draw inspiration from their past while others stress some strengths in current services. Future research should focus on occupational therapy stroke rehabilitation in Colombia’s regions and explore the impact of conflict and post-conflict contexts. In addition, occupational therapists’ efforts to improve professional representation should be explored.