Cultural models of illness causation and treatment inform community understandings of and responses to disability. Data collected as part of a multi‐country study, conducted in 2002–2007, illustrate how villagers from northeastern Thailand conceptualise disability (pikarn). Local understandings of causality are shaped by Buddhist beliefs in accumulated demerit, and this significantly influences attitudes towards illness, adversity and bodily states. Buddhist notions of love and compassion (metta and kurana) inform appropriate responses to people living with disabilities, while local distinctions of ability and disability inform expressions of sympathy and/or pity (songsarn), with implications for the social participation of people with a disability.