Interest in the inclusion of students with special educational needs in mainstream education has increased faster than the actual inclusion of these students in standardised assessment and accountability systems. This chapter discusses the participation and performance of students with special education needs in the Baltic and South Eastern European countries (Croatia, Estonia, Latvia, Lithuania, Serbia, and Slovenia) in PISA 2006. This chapter describes the participation rates by countries and the demographic characteristics of the students with special educational needs as a group, as well as by their disability status. Students’ educational experiences and perceptions are presented as well as their perceptions of their learning behaviours. In general, too few students with special education needs are included in PISA from not enough economies and the conclusions that can be drawn are therefore extremely limited.