Purpose: This study surveyed sources of moral distress within rehabilitation counseling practice. Method: A mixed-methods approach, the study used both quantitative and qualitative analyses. Results: Of the 83 participants who completed the survey, the average rating of moral distress was 4.32 (uncomfortable), with 43% reporting a distress rating of 5 (uncomfortable/distressing) or higher. Based on the descriptions, common sources of moral distress involved: (1) compromised service delivery, client welfare, and resources; (2) conflicts between client, treatment team, and family; (3) leadership and climate; and (4) organizational policy and practice. Conclusions: Implications address areas for ongoing discussion, including considerations for how to address moral distress to potentially reduce professional burnout and compassion fatigue with in rehabilitation counseling.