This presentation explores the pioneering work of Ken Yankelevitz in the history of accessible gaming. Beginning in the 1980s, the trained flight simulation engineer started the non-commercial development of accessible game controllers for individuals who could not use standard input devices. In collaboration with patients from rehabilitation clinics, he created customized solutions during an experimental phase (1980s–1990s) that enabled alternative input methods. Key devices discussed include his mouth controller for quadriplegic gamers and the “Fingertip Controller” for one-handed or hands-free use. The presentation then examines how Yankelevitz distributed these technologies through his company KY Designs (1981–2011), offering both standardized and customized devices at low cost and significantly shaping accessible gaming. Finally, the presentation highlights the QuadStick, which represents the consistent continuation of Yankelevitz’s efforts by Fred Davison.