Scaling-up is the expansion or development of organizational activities to achieve a greater impact. Scaling-up among non-government organizations (NGOs) involved in community based rehabilitation (CBR) is a recent phenomenon. Case study materials from NGOs in India, Canada, and Indonesia are used to illustrate four pathways to scaling-up in CBR and the use of collaboration strategies in these efforts. Discussion focuses on differences between scaling-up in industrialized and less developed countries and on structural characteristics of organizations which influence their pathways.