Introduction: The macro-political and economic changes influence the current labor and employment relations. In Rio de Janeiro State, the increase of occupational therapist work in public health system has been done trhough national health public system. It can be verified by the number of job oportunities and, mainly, from the public tenders. Objective: This study aims to understand how occupational therapists, employed at public health systems, performed their professional practices and how the undergraduate contributes to deal with questions at daily work. Method: This study has a qualitative design and its aim was to characterize the occupational therapists practices that are employed at the Unified Health System in Rio de Janeiro, and to understand the perception and the mainly difficulties faced daily by these professionals. A semi-structured questionnaire was applied. Results: 57 occupational therapists participated in the study, of which 50 professionals were employed at health units in Rio de Janeiro and 7 were teaching in two undergraduated courses in Occupational Therapy with current or past experience in public health units. The majority of the participants have completed their undergraduate studies for more than 15 years. Conclusion: From the aspects analyzed on the training of occupational therapists, it was possible to see that this was not always related to the demands of the public health system. However, some characteristics of the profession seem to facilitate the insertion of this professional in the Unified Health Service (SUS). Therefore, a professional trained with knowledge, skills and appropriated attitudes to public policies and legislation, will have its potential and expertise expanded.