Introduction As society becomes increasingly internationalised, it is important to consider international perspectives on occupational therapy education. There is little research on the experiences and impacts of international learning opportunities such as through academic exchange programmes. The aim of this study was to explore the impacts of an international academic exchange programme among occupational therapy students. Methods This study was conducted as a qualitative research study. Data were collected by in-depth semi-structured interviews with nine participants (three men and six women) who participated in an exchange programme at Thomas Jefferson University in the United States and graduated from Kitasato University in Japan. A grounded theory approach was used to analyse the qualitative data. Findings Educational outcomes were sorted into four categories: experience, reaction, learning and behaviour. Knowledge and experience gained from the international exchange programme had a positive impact on the personal and professional development of the participants. Participants reported that the programme helped them in acceptance of diversity, collaborating beyond boundaries and gaining confidence from challenges. These impacts persisted even after they graduated. Conclusions In an increasingly globalised world, internationalisation of occupational therapy education is significant to build a global community of occupational therapists who seek to improve their practice.