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The World Health Organization (WHO) estimates that 15% of the world’s population is living with disability, a large majority of which can be found in developing nations. Previous studies in Nicaragua have investigated the perceptions of disability among caregivers and noted limited access to rehabilitative services. However, the general knowledge and perceptions of physical therapy services in Nicaragua remains unclear. As a result, this pilot study sought to explore the local knowledge and perceptions of disability and physical therapy services and to characterize the sample from a remote area of northwestern Nicaragua. Participants were recruited using convenience sampling during multidisciplinary medical outreach clinics with OneWorld Health. A nine-question, face-to-face questionnaire was administered using local Nicaraguan translators certified in medical Spanish. A total of 101 participants [16 (15.8%) male, 85 (84.2%) female] were surveyed. A total of 70 (69.3%) report having no knowledge of physical therapy, 79 (78.2%) report no knowledge of anyone who has received physical therapy, and 89 (88.1%) were unaware of any physical therapy services available to them. A total of 94 (93.1%) report having musculoskeletal pain, and 89 (88.2%) report that medications are better at treating their pain. Our results describe the general perception and background knowledge of physical therapy in a unique region of Nicaragua. A very high burden of musculoskeletal complaints, especially neck, low back, and elbow/wrist/hand pain was noted. In large part, it appears that participants from this region have little knowledge of physical therapy and how these services may help them. This study demonstrates that there may be underlying contextual factors, still yet to be uncovered, that influence this communities’ knowledge, perception, and utilization of physical therapy services for physical disability.