In this paper we explore the significance of metaphor and dominant cultural narratives in current autism discourse. We briefly explore the history of metaphor in autism discourse, and outline the contemporary struggle between the culturally dominant metaphor of autism as disease and the emergent counter-narrative of autism within neurodiversity. We argue that metaphor serves very specific purposes in autism discourse, including (1) to create a commonsensical narrative congruence between common understandings of autism and currently dominant notions about its aetiology(ies) or causes(s), and (2) to create a commonsensical narrative congruence between common understandings of autism and currently dominant notions about appropriate responses to or interventions for autism. We argue that the bulk of the support for metaphorically framing autism within a disease model comes from within the non-autistic ('neurotypical' or 'NT') community, whereas the bulk of the support for metaphorically framing autism within a neurodiversity model comes from within the autistic community (and is inclusive of some non-autistic allies as well). In exploring these competing cultural narratives, we argue for the crucial import that counter-narrative can play in the process of cultural critique and resistance to ideological hegemony.