Data collected by the US Department of Education in 2008 indicate that US colleges and universities enrolled 707,000 students with disabilities, divided roughly equally between public and private institutions. The survey found that 31 percent of these students reported learning disabilities, 18 percent ADD or ADHD, 15 percent mental illness or psychiatric conditions, and 11 percent other types of health impairment (Raue and Lewis, 2011, p. 3). The sheer number of students with disabilities suggests that most, if not all, colleges and universities are dealing with the need to accommodate some of their students. Section 504 of the Rehabilitation Act of 1973 has required "reasonable and effective accommodations" for students with disabilities in any educational institution receiving federal funds (including financial aid) for several decades. The passage of the Americans with Disabilities Act of 1990 (ADA) heightened public interest in the issues faced by individuals with disabilities in education, employment, and access to public accommodations. It has also stimulated considerable litigation. Many colleges and universities have special offices that deal with the needs of these students and manage the accommodation process. In recent years, even those institutions with experienced staff and dedicated offices have faced new and complex challenges. Litigation involving students with disabilities has increasingly focused on four issues that are difficult to resolve for both educational and logistical reasons: (1) Visually impaired students have challenged the use of e-readers and other digital hardware that may not be fully accessible to students who cannot read text; (2) Some students with psychiatric disorders have requested that they be permitted to bring a "comfort animal" to campus and perhaps even to class; (3) The US government has imposed stricter requirements on colleges that wish to exclude students who may be a danger to themselves; and (4) Students with disabilities enrolled in graduate programs with a clinical component who have excelled in traditional classroom-based learning but have difficulties with hands-on clinical education have become more likely to challenge their dismissals from these programs. As science progresses and more is learned about the nature and cause of physical and mental disorders, new accommodation requests and justifications will undoubtedly arise, and college leaders will need to develop policies to address emerging issues that were unrecognized even a few years ago. Additional resources are provided.