Over the past 20 years, survival of youth with special health care needs, including youth with rheumatic diseases, has markedly improved. Over 90% will survive past their twentieth birthday and health care providers are recognizing a need for transition services to assist youth with disabilities to become successful adults. The barriers to, and the principles of, transition services are outlined. A discussion of available models and assessment tools for transition readiness and lessons learned on how to provide successful transition services is included.