Choice, a concept included in the quality of life approach, is frequently referred to in quality of life and related literature, but its components have not been described clearly. Drawing on conceptual considerations and research reports, the authors review and extend what is known about choice, and set out a conceptualization of its two main components: available opportunities and choice-making. The most important characteristics of opportunities are breadth and familiarity, and the most important characteristics of choice making are freedom, initiative, and skill. The authors consider the application of choice to supports and services by discussing numerous practical issues and providing suggestions for application. These are summarized as an overall four-step strategy for moving forward that sets the scene for more specific strategies to be developed and evaluated. (Contains 1 figure and 2 tables.)