Disabled children’s opportunity to act as agents may be compromised because adults have the power to choose who are entitled to express agency. Disabled children spend much time in institutions and with professionals of different fields. The aim of this literature review was to find out which factors facilitate or hinder the realization of disabled children’s agency in institutional contexts. As data we used 19 research articles and analysed them with inductive content analysis. Key factors relate to professionals’ attitudes towards diversity, children and themselves as well as professionals’ communication skills and institutional factors that enable the child to have an influence or prevent it and which give or do not give room for children’s peer relationships. Rethinking the child and adult view and learning dialogical communication are recommended in the education of all fields that work with disabled children.