This article reviews the current literature on play and play assessment in occupational therapy. The concept of play and play theories are examined and reasons are investigated for the low use of play assessment in paediatric occupational therapy practice. Within contemporary occupational therapy practice, the concept of play is being readdressed and play behaviour is understood to be important in child development. Available assessments of play in occupational therapy assess the child in a familiar environment to the child. Since many paediatric occupational therapists work in clinical settings, it is concluded that a clinically viable assessment of observation of play behaviour is required within occupational therapy. Parameters for such an assessment are proposed.