There are two disparate ways to describe the relationship between digital games and special needs (i.e., physical, cognitive and even socio-cultural conditions than require specific interventions in everyday life routines, learning activities, and general accessibility). On one hand, it can be argued that the sector is becoming more inclusive. For instance, assistive technologies are gaining a foothold in the game industry with innovative hardware (e.g., the Microsoft Adaptive Controller), focused efforts of researchers and practitioners (e.g., the IGDA game accessibility interest group or the Games For Health conferences), increased customization interfaces and input systems (e.g., those offered in the games Overwatch or Uncharted 4), and focused funding initiatives (e.g., AbleGamers Charity and Special Effect). Conversely, one could also argue that the concerns of individuals with special needs represent an overlooked area. For example, toxicity and disruptive behaviors across game audiences (e.g., “Gamergate”) represent additional sources of biases, games are not accessible to all players, and the literature about special needs and gaming is scarce (with some notable exceptions). Additional research is required to respond to these opposing perspective as well as to further impact policy and practice. There are least four reasons to justify such a claim: 1) Video games are at the forefront of technological adoption; 2) Video games and interactive media shape society and culture; 3) The combination of technical and cultural perspectives can effectively support two leading approaches to individuals with special needs; 4) Videogames can potentially support special education and learners with disabilities, from improving physical and social skills to facilitating communication and self-organization. The goal of this special issue of GAME is to provide insights and guidelines for realizing and responding to this potential.