Affirming and strengths- based practice with lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals and communities started to become more mainstream in the 1970s and 1980s and continues today. Whereas stigmatization of LGBTQ individuals and communities was once the accepted norm, most mainstream professional organizations in social work and allied helping professions today treat LGBTQ identity as part of the normal spectrum of human experience and support affirming and strengths- based models of practice with LGBTQ communities (American Counseling Association, 2013; American Psychological Association [APA], 2008; Council on Social Work Education [CSWE], 2015; National Association of Social Workers, 2005). In this chapter, we describe affirming and strengths- based practice with LGBTQ individuals and communities and consider the context in which these practice models emerged. Additionally, we explore the various theoretical and practice models that are the foundation of affirming and strengths- based practice with LGBTQ communities and consider the efficacy of these service approaches.