Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Young Children's Participation and Environment Measure (YC-PEM) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The objective is to cross-culturally translate, adapt, and pilot test the YC-PEM into the Dutch language and culture. In total 3 cognitive interviews with caregivers and one focus group with Occupational Therapists (N = 5) working in early intervention were conducted to evaluate the cultural relevance of the YC-PEM content for use in a Dutch context. Data was analyzed by content analysis using semantic, idiomatic, content, and conceptual equivalence. The YC-PEM was pilot tested with 31 caregivers of children with and without disabilities. Setting specific estimates of internal consistency and test-retest reliability were obtained. Results show adaptations mainly focused on content and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Internal consistency estimates varied from 0.42 to 0.93 for the participation scales and from 0.74 to 0.83 for the environmental scale. This study gives preliminary evidence for the use of a culturally adapted YC-PEM in Belgium and the Netherlands. Further validation in a larger sample is indicated to evaluate its psychometric properties.