Students with ADHD struggle in higher education as a result of various functioning and participation problems. However, there are remaining gaps in the literature. First, it remains unclear how often and during which teaching and evaluation methods problems arise. Second, we do not yet know which reasonable accommodations are most effective to deal with the functioning. And third, we do not know which accommodations are most effective to address participation problems of students with ADHD in higher education. This study addresses these three gaps in literature. In total, 86 students with ADHD, 42 student counsellors and 86 students without a disability participated in a survey-based study. The results show that students with ADHD most frequently experience problems with sustaining and focusing attention and it is demonstrated that most problems arise during classical teaching or evaluation methods. Finally, the perception of the effectiveness of reasonable accommodations is strongly dependent on which problems students experience in higher education. These findings suggest that it is important to consider both personal and environmental characteristics when selecting and implementing reasonable accommodations.