Water skiing has been adapted so that physically disabled athletes can participate and compete. Tournaments offer slalom, tricks and jumping events for vision impaired individuals (blind or partially sighted), multiplegics (paraplegics and quadriplegics), leg amputees (above and below knee), arm amputees and athletes with both arm and leg disabilities. The skiers in the latter three categories compete with the same water ski equipment used by able-bodied athletes and have the option of using a prosthesis.

Vision impaired athletes do not require special equipment. However, they are guided by another skier in the jumping event, although they must be released before they go over the ramp and use audible signals instead of buoys in the slalom course.

Multiplegic athletes use a sit ski, which is larger than the ski of an able-bodied skier and includes a cage similar to that used in snow skiing.

A narrower slalom course than that set out for able-bodied competitors is an option for those whose disability is greater such as quadriplegics and athletes with both arm and leg disabilities.