This article reports on a national study conducted in the United States on the current institutional practices, structures, resources and policies that are needed to ensure online accessibility for all students at colleges and universities. Key findings include the need to better articulate who is responsible for online accessibility initiatives and policies; the need for an institutional investment when creating accessible online environments in terms of technology, staffing and other resources; and a sense of overwhelm at many institutions that are unsure of where to begin with making their online programmes and courses accessible for all students.