This book arises from the challenges and difficulties involved in the evaluation and management of concussions in wheelchair athletes. Concussions are most readily identified in the ambulatory population via identifying gross motor instability or when athletes lose their balance and stumble after a blow to the head or neck region. Because wheelchair athletes participate in sport while sitting down and using a wheelchair, clinicians must be extra attentive to identify a potential concussion. Once a potential concussion is identified, there are many challenges in evaluation of the wheelchair athlete population due to their comorbidities. At baseline, they may have signs and symptoms that mimic a concussion, and their impairments can also alter their cognitive and balance assessments. Therefore, it is critical to make a distinction between these athletes  baseline comorbid impairments and potential new exam findings in a concussion.