Abstract
<jats:p>Objective: To discuss regional asymmetries in Brazilian academic-scientific production in light of the concepts of coloniality of power, internal colonialism, and coloniality of knowledge, reflecting on their implications for the field of occupational therapy. Method: A theoretical essay of a reflective-interpretative nature, developed based on decolonial literature and studies on regional inequalities, articulating conceptual categories with contextual analysis and the academic-scientific production in occupational therapy. Results: Historical processes of epistemic subalternization of the Northeast were identified, linked to the dynamics of coloniality of power and knowledge. It was also discussed that the academic and scientific hierarchies arising from these processes may be expressed in the field of occupational therapy. Conclusion: It is recommended to strengthen reparative actions and Northeastern academic-scientific networks in order to address regional inequalities and to rewrite the histories of occupational therapy from the perspective of the Brazilian Northeast.</jats:p>