How to Create Accessible PDFs for Screen Readers

285 Million Reasons to Care About PDF Accessibility

That's roughly how many people worldwide have significant vision impairment. When you publish an inaccessible PDF, you're putting up a "closed" sign for a substantial portion of your audience.

Beyond the moral argument, there's a legal one. The ADA, Section 508, and the European Accessibility Act all require organizations to provide accessible digital documents. Lawsuits over inaccessible PDFs have been climbing steadily since 2018.

The good news: making a PDF accessible isn't that hard once you know what to do.

What Makes a PDF "Accessible"?

A screen reader (like JAWS, NVDA, or VoiceOver) doesn't see your document the way you do. It reads the underlying structure — tags, reading order, and metadata. A visually beautiful PDF can be completely incomprehensible to a screen reader if it lacks this structure.

An accessible PDF needs:

• Document tags that define headings, paragraphs, lists, and tables
• Reading order that matches the visual layout
• Alt text for every image, chart, and graphic
• Proper table structure with header rows defined
• Bookmarks for documents longer than a few pages
• Document language specified in the metadata
• Sufficient color contrast (4.5:1 minimum for body text)

Start at the Source

The easiest way to create an accessible PDF is to start with an accessible source document. Retrofitting accessibility into a finished PDF is always harder.

From Microsoft Word

Word has decent accessibility tools built in:

1. Use Heading styles (Heading 1, Heading 2, etc.) instead of just making text bold and bigger
2. Add alt text to all images (right-click → Edit Alt Text)
3. Use actual tables for tabular data (not tabs or spaces to create columns)
4. Define table headers (Table Properties → Row → "Repeat as header row")
5. Run the Accessibility Checker (Review → Check Accessibility)
6. Export to PDF using "Save As PDF" with "Document structure tags for accessibility" checked

From Google Docs

Google Docs handles this reasonably well:

1. Use heading styles from the toolbar
2. Add alt text to images (right-click → Alt Text)
3. Use built-in list formatting
4. Download as PDF — Google preserves heading structure in the export

From InDesign

InDesign gives you the most control:

1. Use paragraph styles mapped to PDF tags
2. Set reading order in the Articles panel
3. Add alt text in Object Export Options
4. Export with "Create Tagged PDF" checked

Fixing an Existing PDF

Sometimes you inherit a PDF that's already created and it's not accessible. Here's how to fix it.

Check Current Accessibility

Before fixing anything, assess what you're working with:

1. Open the PDF and try selecting text. If you can't select any text, it's probably a scanned image — you'll need to run OCR first using MyPDF's OCR tool
2. Check if tags exist (in Acrobat: View → Navigation Panels → Tags)
3. Try reading the document with a screen reader to identify problems

Add Structure Tags

If the PDF has no tags, you need to add them. Adobe Acrobat Pro can auto-tag documents (Accessibility → Autotag Document), though the results often need manual correction.

For documents without complex layouts, converting to Word first can actually help:

1. Convert PDF to Word
2. Fix the heading structure in Word
3. Add alt text to images
4. Re-export as a tagged PDF

Fix Reading Order

Screen readers follow the tag order, not the visual layout. In multi-column documents, the reading order often zigzags nonsensically — reading across both columns instead of down one column then the other.

You need to manually check and correct the reading order to match the intended flow.

Write Good Alt Text

Alt text describes what an image shows. Some guidelines:

• Be specific: "Bar chart showing Q3 revenue at $2.4M, up 15% from Q2" beats "Chart"
• Be concise: 1-2 sentences is usually enough
• Skip decorative images: Purely decorative elements (borders, spacers) should be marked as artifacts, not given alt text
• Don't start with "Image of": Screen readers already announce "Image" — saying "Image of a dog" results in "Image: Image of a dog"

Table Accessibility

Tables are notoriously difficult for screen readers. The reader needs to know which cells are headers so it can announce "Column: Revenue, Row: Q3, Value: $2.4M" instead of just reading numbers in sequence.

Make sure:

• Header rows are tagged as not


• Tables have a summary describing their purpose


• Complex tables are simplified when possible (split merged cells, avoid nested tables)

Testing Your Accessible PDF

Creating an accessible PDF without testing is like writing code without running it. You need to verify.

Automated Checks

• Acrobat's Accessibility Check (Accessibility → Full Check) catches structural issues
• PAC (PDF Accessibility Checker) — free tool that checks against PDF/UA standards
• Both will flag missing alt text, reading order problems, and structural issues

Manual Testing

Automated checks catch maybe 30% of real accessibility problems. You also need to:

1. Tab through the document — does the focus move in a logical order?
2. Use a screen reader — NVDA is free on Windows, VoiceOver is built into Mac. Listen to your document being read aloud.
3. Check color contrast — use a contrast checker tool on any colored text

Quick Accessibility Checklist

Before publishing any PDF:

• [ ] Document has a title in the metadata
• [ ] Language is specified
• [ ] All text is selectable (not a scanned image)
• [ ] Headings use proper heading tags (not just bold text)
• [ ] All images have alt text
• [ ] Tables have defined header rows
• [ ] Reading order matches visual layout
• [ ] Links have descriptive text (not "click here")
• [ ] Color is not the only way information is conveyed
• [ ] Font size is at least 10pt for body text

PDF/UA — The Accessibility Standard

PDF/UA (Universal Accessibility) is the ISO standard for accessible PDFs. It's essentially WCAG applied specifically to PDFs. If your organization needs to comply with accessibility regulations, PDF/UA compliance is the benchmark to aim for.

Getting there takes effort, but every step you take makes your documents usable by more people. And honestly, the structural improvements that accessibility requires — clear headings, logical reading order, described images — make documents better for everyone, not just screen reader users.