This article reviews the relationship between social protection and disability in theory and practice. Persons with disabilities and their families may be considered among the most worthy recipients of social protection due to their vulnerability to chronic poverty and social exclusion. A review of cash transfer programmes for persons with disabilities reveals positive economic, social and service access outcomes. However, coverage and benefit levels remain low. This article calls for the state to play a greater role in the provision of social assistance for persons with disabilities in developing countries. Policies and programmes which protect economic security should be combined with those which promote an enabling environment in which people can achieve security of livelihood.