BACKGROUND: Access to adaptive sports for children and adolescents with disabilities is essential to improving the mental and physical health of this population in the U.S. However, very limited resources to participate in adaptive sports are provided to children and adolescents with disabilities, with very few tracking systems to determine if U.S. schools are offering activities to cater to this specific population. METHODS: In this commentary, we use data from the National Federation of High Schools (NFHS) to assess the extent to which several types of adaptive sports are offered in high schools across each U.S. state between 2003 and 2023. RESULTS: The analysis assessed 13 different types of adapted sports that the NFHS has collected annually between 2002 and 2023. The data showed that 25 states indicated offering at least one adapted sport within a school during this 22-year period (at least one school in a state offered adapted sports)-25 states did not indicate any schools offering at least one adapted sport. CONCLUSION: More research needs to be done in the area of understanding the provision of sport for individuals with disabilities from multiple perspectives, along with a stronger effort to track how these opportunities are being equitably provided across schools in the U.S.