This study investigated pre-occupational therapy students' descriptions of dissonance during a two-week service-learning immersion program in Guatemala. Thirty-one students participated in student-led group reflections during two program iterations. Qualitative analysis of transcripts yielded three themes: context, experience, and outcome. The interconnectedness of all three themes illustrates the interdependence of intense, international service-learning experiences, critical reflection, and transformation. Findings suggest the impact of international service-learning experiences on student development.