To expand the reach of health-promotion efforts for people with disabilities, we piloted a health-coaching intervention with a disability-specific curriculum. We evaluated the intervention's effects on health-related quality of life and health behavior change. Mixed-methods research design using pre-post measures and semi-structured interviews. A convenience sample of community-dwelling adults with disabilities (n = 39). Participants engaged in a curriculum-based health coaching intervention, titled Health My Way, which used weekly one-on-one coaching for up to 12weeks. Participants completed pre- and post-intervention surveys including questions from the Health-Related Quality of Life (HRQOL) measure and the Health-Promoting Lifestyle Profile II. A subset of participants completed in-depth interviews to explore how health coaching influences health behavior change (n = 12). We found statistically significant effects on poor-health days due to physical and mental health, and effects on physical activity. We saw additional effects with engagement in relevant curriculum content. Qualitative main themes (tailoring of information, enthusiasm for personally meaningful goals, and social support) indicated processes by which health coaching supported health behavior changes. The results of this pilot study indicate health coaching appears to be effective for improving HRQOL and health behavior, especially physical activity, for people with disabilities. Apparent key factors include enthusiasm for personally meaningful goals, having tailored information, and social support.