The article explores the evolution of adaptive sports in Russia from a rehabilitation tool to a professional domain of high-performance sports. Cases of organizations in the Saratov region (State Autonomous Institution of Additional Education “RIF”, State Budgetary Institution “Nadezhda Gubernii”) are examined in detail as an illustration of nationwide processes. It is established that professionalization is manifested through integration into the international sports community, the implementation of a multi stage training system (from beginner to elite levels), and the reorientation of governing bodies from social protection to sports authorities. The key goal has become the training of reserves and elite athletes for victories at the Paralympic Games and World Championships. Legal heterogeneity is identified: legislation lacks clear distinctions between the concepts of “adaptive physical culture,” “rehabilitation,” and “sports for persons with disabilities.” Adaptive sports in Russia have established themselves as a full fledged professional discipline. For sustainable development, systematic detailing of the legislative framework is required to eliminate terminological contradictions and optimize management.