Brings together players with autism, Down syndrome, traumatic brain injury, and other cognitive disabilities, often through Unified Doubles, in which one player with intellectual and/or developmental disabilities competes alongside one player without IDD, with the unified partner there to maintain rallies and support their partner rather than dominate play. Programs like ACEing Autism and Buddy Up Tennis build skills through routine and constant encouragement, and the USTA National Adaptive Tennis Championships at the USTA National Campus now include a singles invitational alongside the traditional Unified Doubles competition.

For players with a physical disability who play standing rather than from a wheelchair, with adaptations such as use of adaptive equipment, like a prosthetic, an orthotic, or a brace, and a change in rules such as two bounces allowed. Courts, balls, and match length can flex too, but many adaptive standing players play with no modifications to the game and train and compete against players who do not have disabilities.

Played with the same rules, racquets and courts as mainstream tennis, no equipment modifications needed. What changes is communication: players rely on visual cues such as hand signals, gestures and facial expressions, and in international competition, athletes with a hearing loss of 55 decibels or greater in their better ear are eligible, with visual cues like flashing lights the only adaptation made. The path runs from local clubs all the way to the Deaflympic Games.