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Objectives Studies of autism among Indians in India and the United States are limited. Our objective was to conduct a mixed-methods evaluation of autism knowledge, attitudes, and practices (KAP) to explore factors that impact autism identification and care access in both ethnocultural communities.Methods Twenty-three semi-structured interviews (n=13 India, n=10 US) were conducted with caregivers, teachers, and clinicians, and were manually coded using inductive thematic analysis. Interviews informed the development of a KAP survey, which was deployed to Indian caregivers of children (ages 1-10 with and without autism) in India (N=100) and the US (N=44). Survey items assess demographics and general autism knowledge, attitudes and practices, and service system questions for caregivers with autistic children.Results Qualitative data revealed challenges, including limited parental knowledge, disability stigma, service system burden, and inadequate community and familial support systems in India and US. Some setting-specific barriers included acculturative stress (US) and lack of standardized diagnostic practices (India). Quantitative data extend these findings. For instance, while caregivers in both settings endorsed limited knowledge about autism and associated services (India: 90%; US: 97%), US caregivers reported more desire to learn about autism (India: 29%; US: 46%), underscoring the need for context driven sensitization efforts.Conclusions This is the first global collaboration aimed at understanding autism KAP across Indian communities in India and the US. Our findings suggest shared challenges and setting-specific differences in autism perspectives and highlight the value of bi-directional knowledge exchange for development of equitable autism care solutions across settings.