(Purpose) Students who are deaf or hard of hearing (SDHH) are a low-incidence group of students; however, SDHH also have a high incidence of additional disabilities (SDHH+). Many SDHH and SDHH+ require accommodations for equal access to classroom instruction and assessment, particularly in mainstreamed educational settings where spoken English is the primary language. Accommodations for SDHH, overall, have increased under federal legislation including the Individuals with Disabilities Education Improvement Act and the No Child Left Behind Act. Unfortunately, specific practice recommendations for SDHH+ and their unique needs are often lacking in the research literature. (Methodology) This article presents findings regarding accommodations use by SDHH and SDHH+ from the National Longitudinal Transition Study 2. (Conclusions) Initial logistic regression analysis found no differences in accommodations use of SDHH and SDHH+. However, logistic regression analysis that compared specific additional disability groups with the larger overall SDHH group did find differences in accommodations use for two SDHH+ groups: students who had a learning disability and students with attention deficit hyperactivity disorder. (Recommendations) This article includes a discussion of the implications of these findings for both research and practice.