This article presents reflections on including disability in social protection and, specifically, in social assistance programmes. The main considerations for including disability in such programmes are: (a) the factors associated with disability that create vulnerabilities for people with disabilities and their household (e.g. social exclusion, the need for care and extra costs); (b) the nature of disability targeting within social protection and social assistance programmes; and (c) the measurement of disability – a complex but key factor in ensuring accurate targeting and monitoring of impact. This article describes these considerations in relation to experiences in three African countries – Uganda, Zambia and South Africa – and concludes with recommendations on recognition of disability as a vulnerability factor, and how targeting and measurement can and should be addressed for inclusion of disability in social assistance programmes.