The inclusion of children with disabilities within general physical education contexts poses challenges in maximizing their learning potential. The purpose of this case study was to investigate physical activity levels and correct motor skill trials of a child with a developmental delay in relation to her typically developing peers and the extent to which the physical education teacher made the learning environment inclusive. Nineteen children (12 boys, 7 girls; mean age 8 years) and their physical education teacher (female, 50 years) from one second grade elementary school class in Wallonia (Belgium) participated in this study. The physical activity levels and motor skill trials of an eight-year-old girl with developmental delays caused by a metabolic disease was compared to her typically developing peers. Systematic observation was used to asses physical activity levels and skill trials, while the Lieberman-Brian Inclusion Rating Scale for Physical Education (LIRSPE) was used to assess the teacher. Inter observer agreement for all variables was above 87%. During physical education Emily spent 29% of time on MVPA, which was lower than her peers in three out of five lessons. Similar results were found for total skill trials and skill trials/min, while for percentage correct skill trials values were lower during all lessons. The LIRSPE ratios per lesson varied from 3.21-3.53. However this does not confirm that the setting was highly inclusive. Interactions between children with disabilities, their peers and teachers should be the topic of future studies.