Adaptive athletes have globally embraced the sport of adaptive cycling, and participation is expanding rapidly on local, national, and international levels. With a diverse array of events supporting adaptive cyclist participation, there is a need to create more awareness about the history and classes of adaptive cycling, adaptive cycle technology, and injuries and medical concerns specific to this group of adaptive athletes. This communication aims to review the major aspects of adaptive cycling, from the technological aspects of both the cycles and adaptations of the athlete to injuries and medical concerns specific to adaptive cyclists.