The transition from early intervention to preschool is a major early milestone for children with multiple disabilities and their families and the first of many transitions they will experience across the lifespan. However due to the low-incidence nature of multiple disabilities, this group has been largely left out of the literature surrounding this transition. Thus, in this paper we review the existing literature in order to better understand the barriers families face during the transition from EI to preschool, and how this transition could be improved for parents of children with complex physical, medical and educational needs. Several challenges experienced by families as well as beneficial systems of support are presented. Implications for practice and further research examining the specific needs of families of children with multiple disabilities during transition are discussed.