Universal design and assistive technology present advantages and disadvantages in accommodating the needs of people with disabilities. The best solution may be a combination of the two, using universal design wherever possible and commercially practical and using assistive technologies wherever it is necessary or provides sufficient additional advantage to the user. Three approaches are discussed for the individual who is unable to interact with their world: change the individual, provide them with tools they can use, or change the environment. Examples of each are illustrated using personal workstations and shared, public, and encountered systems. The final decision may rest on commercial practicality, and several new technologies are explored. Ultimately, we need to continue to move forward both on the universal design and the assistive technology fronts if we are to address the needs of people with disabilities and those who are aging.