Introduction: The expansion of autism diagnosis and the market built around this topic have influenced the professional practice of Brazilian occupational therapists. Objective: The objective of the study was to map and characterize the professional practice of occupational therapists who work with this population in the State of São Paulo (Brazil). Method: This is an excerpt from an exploratory doctoral research, with a qualitative approach, carried out with occupational therapists working in different practice scenarios. Data collection took place online, through semi-structured interviews, from September to December 2023, and the data were analyzed based on Content Analysis. Results: In total, 24 occupational therapists participated. Although most of the participants were working in private clinics specialized in autism, territorial, community and inter and intrasectoral network work was indicated as necessary to care for autistic children and adolescents. Regarding the concept of autism, for most participants, it is linked to the biomedical perspective and the profession is gaining more prominence due to the increase in the prevalence of the diagnosis, despite suffering from market impacts. Sensory Integration and Applied Behavior Analysis are the main theoretical references used. Conclusion: Occupational Therapy has been called to reflect on its practices in different care settings. Therefore, it is important to investigate how Brazilian occupational therapists develop their professional practice to ensure investments and possible advancement in the proposals of public policy agendas for care.