Although educational policies differ across countries, there appear to be clear commonalities across a global context in some aspects of the utilisation of special education paraprofessionals and their relationships with special education teachers. Research and federal education policies in the United States highlight the importance of ensuring access to general education curriculum and settings for students with disabilities. In response to students' needs for support in general education settings, schools have widely turned to the utilisation of paraprofessionals, which can present challenges. This qualitative study explored the perspectives of 64 special education teachers and paraprofessionals across 11 focus groups, focused on the key issues that arise when working together to support students with disabilities in general education settings. We used inductive qualitative analysis to identify four themes of key issues, related to: (a) shared ownership of student learning, (b) planning and implementing appropriate supports, (c) navigating collaborating roles, and (d) facilitating the bridge between general and special education. We offer recommendations for future research and practice, including for teachers, paraprofessionals, administrators, and teacher preparation personnel.