There is ample evidence on the positive effects of the family meal for children and families, but few of these studies have examined families where a child has autism. In order to better understand (1) the nature of shared family meals when a child has autism, (2) how families establish useful mealtime routines and meaningful mealtime rituals, (3) what are the barriers to achieving the family meal, and (4) the role mealtime rituals and routines play in family life I analyzed recorded observations of family dinners in the home and interviews with mothers of 16 Midwestern families. Each family had at least one child between the ages of 5 and 14 with autism. The families in this study shared many of the universal features of mealtimes such as using the time to share and problem solve, but they also had features salient to their identities as autistic families. For example, having to anticipate throughout the meal their children’s capacities and limitations. The creation of useful routines was enmeshed with the creation of meaningful rituals. Logistical considerations, the ideal family meal, and the family-of-origin-family-meal placed constraints on what the mealtime routine could be. The repetition of routine created symbolic meaning which, in turn, both reinforced and reflected family functioning. Thus, family meals were a symbol unto themselves and the enactment of them had the potential to create connection and communicate closeness; this was predicated upon the families ability to negotiate a dialectic of acceptance and control.