Abstract In this article, I propose that the unique end, or goal, of occupational therapy is to help persons with performance deficits of any kind make and express meaning through organized human performance, which I call occupation. To support this thesis, I show that, too often, philosophers, psychologists, and others who have studied meaning do not see human performance as a crucial way of making and expressing meaning. This article challenges the assumption that meaning making is only a cognitive process in which Language is its primary expression and shows that the nature of humans is to make meaning through occupation. Furthermore, this article reveals why occupational therapy should emphasize human performance and its role in meaning making. Finally, I propose that occupation is properly defined as intentional human performance organized in number and kind to meet the demands of self maintenance and identity in the family and community. I justify this definition and discuss the likely therapeutic nature of occupation and examples of the end, or goal, of occupational therapy.