diff --git a/Doc/library/tkinter.rst b/Doc/library/tkinter.rst
index ca034fcdc09b43..6cea5705f3b691 100644
--- a/Doc/library/tkinter.rst
+++ b/Doc/library/tkinter.rst
@@ -1894,6 +1894,75 @@ Base and mixin classes
 
       .. versionadded:: next
 
+   The following methods support assistive technologies such as screen
+   readers.
+   They require Tk 9.1 or newer.
+   Tk automatically exposes the standard widgets to the platform
+   accessibility API;
+   these methods allow overriding the exposed attributes and registering
+   custom widgets.
+   If no assistive technology is active when the application starts,
+   all these calls (except :meth:`!tk_check_screenreader`)
+   have no effect and return ``0``.
+
+   .. method:: tk_check_screenreader()
+
+      Return whether a screen reader is currently running.
+
+      .. versionadded:: next
+
+   .. method:: tk_set_acc_role(value)
+               tk_set_acc_name(value)
+               tk_set_acc_description(value)
+               tk_set_acc_value(value)
+               tk_set_acc_state(value)
+               tk_set_acc_action(value)
+               tk_set_acc_help(value)
+
+      Set an accessible attribute of the widget.
+      The supported roles are ``Button``, ``Canvas``, ``Checkbutton``,
+      ``Combobox``, ``Entry``, ``Label``, ``Listbox``, ``Menu``,
+      ``Notebook``, ``Progressbar``, ``Scale``, ``Scrollbar``,
+      ``Spinbox``, ``Table``, ``Text`` and ``Tree``.
+
+      .. versionadded:: next
+
+   .. method:: tk_get_acc_role()
+               tk_get_acc_name()
+               tk_get_acc_description()
+               tk_get_acc_value()
+               tk_get_acc_state()
+               tk_get_acc_action()
+               tk_get_acc_help()
+
+      Return an accessible attribute of the widget.
+      Raise :exc:`~tkinter.TclError` if the attribute has not been set.
+
+      .. versionadded:: next
+
+   .. method:: tk_add_acc_object()
+
+      Register the widget with the platform accessibility API.
+      This is only needed for custom widgets;
+      the standard widgets are registered automatically.
+
+      .. versionadded:: next
+
+   .. method:: tk_emit_selection_change()
+
+      Notify the platform accessibility API that the selection in the
+      widget has changed.
+
+      .. versionadded:: next
+
+   .. method:: tk_emit_focus_change()
+
+      Notify the platform accessibility API that the widget has received
+      focus.
+      Not available on macOS.
+
+      .. versionadded:: next
+
    The methods with the ``busy_`` prefix manage the busy state of a window,
    which shows a busy cursor and ignores user input.
 
diff --git a/Doc/whatsnew/3.16.rst b/Doc/whatsnew/3.16.rst
index e8c75d2f571061..dd7af01958cbcc 100644
--- a/Doc/whatsnew/3.16.rst
+++ b/Doc/whatsnew/3.16.rst
@@ -358,6 +358,18 @@ tkinter
   report the user idle time.
   (Contributed by Serhiy Storchaka in :gh:`151881`.)
 
+* Added :mod:`tkinter` support for the Tk 9.1 accessibility API: the
+  :meth:`~tkinter.Misc.tk_set_acc_role` and
+  :meth:`~tkinter.Misc.tk_get_acc_role` families of methods which set and
+  return the accessible attributes of a widget, the
+  :meth:`~tkinter.Misc.tk_add_acc_object`,
+  :meth:`~tkinter.Misc.tk_emit_selection_change` and
+  :meth:`~tkinter.Misc.tk_emit_focus_change` methods which register custom
+  widgets with the platform accessibility API, and the
+  :meth:`~tkinter.Misc.tk_check_screenreader` method which reports whether
+  a screen reader is running.
+  (Contributed by Serhiy Storchaka in :gh:`145578`.)
+
 * Added new window-management methods :meth:`~tkinter.Misc.winfo_isdark`
   (dark mode detection), :meth:`~tkinter.Wm.wm_iconbadge` (application icon
   badge) and :meth:`~tkinter.Wm.wm_stackorder` (toplevel stacking order).
diff --git a/Lib/test/test_tkinter/test_misc.py b/Lib/test/test_tkinter/test_misc.py
index 5f75b8d245b3e9..0898cba72b50a8 100644
--- a/Lib/test/test_tkinter/test_misc.py
+++ b/Lib/test/test_tkinter/test_misc.py
@@ -599,6 +599,35 @@ def test_tk_inactive(self):
         # Resetting the timer returns None and does not raise.
         self.assertIsNone(self.root.tk_inactive(reset=True))
 
+    @requires_tk(9, 1)
+    def test_accessibility(self):
+        # Without an active screen reader every "tk accessible" call is
+        # a no-op returning 0, so only test that the calls do not raise
+        # and check the values when a screen reader is active.
+        try:
+            sr = self.root.tk_check_screenreader()
+        except tkinter.TclError:
+            # Tk 9.1a0 or Tk compiled without accessibility support
+            # (e.g. without ATK on X11).
+            self.skipTest('the "tk accessible" command is not supported')
+        self.assertIsInstance(sr, bool)
+        f = tkinter.Frame(self.root)
+        for attr in ('name', 'description', 'value', 'state',
+                     'action', 'help'):
+            with self.subTest(attr=attr):
+                getattr(f, f'tk_set_acc_{attr}')('spam')
+                result = getattr(f, f'tk_get_acc_{attr}')()
+                if sr:
+                    self.assertEqual(result, 'spam')
+        f.tk_set_acc_role('Label')
+        result = f.tk_get_acc_role()
+        if sr:
+            self.assertEqual(result, 'Label')
+        f.tk_add_acc_object()
+        f.tk_emit_selection_change()
+        if self.root._windowingsystem != 'aqua':
+            f.tk_emit_focus_change()
+
     def test_wait_variable(self):
         var = tkinter.StringVar(self.root)
         self.assertEqual(self.root.waitvar, self.root.wait_variable)
diff --git a/Lib/tkinter/__init__.py b/Lib/tkinter/__init__.py
index 83d11a7695ffbe..2e97d667a54ed4 100644
--- a/Lib/tkinter/__init__.py
+++ b/Lib/tkinter/__init__.py
@@ -818,6 +818,92 @@ def tk_inactive(self, reset=False, *, displayof=0):
         else:
             return self.tk.getint(self.tk.call(args))
 
+    # Accessibility support for assistive technologies such as screen
+    # readers.  Requires Tk 9.1 or newer.  If no assistive technology
+    # is active when the application starts, all these calls (except
+    # tk_check_screenreader()) have no effect and return 0.
+
+    def tk_check_screenreader(self):
+        """Return whether a screen reader is currently running.
+
+        Requires Tk 9.1 or newer."""
+        return self.tk.getboolean(self.tk.call(
+                'tk', 'accessible', 'check_screenreader'))
+
+    def tk_set_acc_role(self, value):
+        """Set the accessible role of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_role', self._w, value)
+
+    def tk_get_acc_role(self):
+        """Return the accessible role of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_role', self._w)
+
+    def tk_set_acc_name(self, value):
+        """Set the accessible name of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_name', self._w, value)
+
+    def tk_get_acc_name(self):
+        """Return the accessible name of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_name', self._w)
+
+    def tk_set_acc_description(self, value):
+        """Set the accessible description of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_description',
+                     self._w, value)
+
+    def tk_get_acc_description(self):
+        """Return the accessible description of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_description',
+                            self._w)
+
+    def tk_set_acc_value(self, value):
+        """Set the accessible value of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_value', self._w, value)
+
+    def tk_get_acc_value(self):
+        """Return the accessible value of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_value', self._w)
+
+    def tk_set_acc_state(self, value):
+        """Set the accessible state of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_state', self._w, value)
+
+    def tk_get_acc_state(self):
+        """Return the accessible state of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_state', self._w)
+
+    def tk_set_acc_action(self, value):
+        """Set the accessible action of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_action', self._w, value)
+
+    def tk_get_acc_action(self):
+        """Return the accessible action of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_action', self._w)
+
+    def tk_set_acc_help(self, value):
+        """Set the accessible help text of the widget."""
+        self.tk.call('tk', 'accessible', 'set_acc_help', self._w, value)
+
+    def tk_get_acc_help(self):
+        """Return the accessible help text of the widget."""
+        return self.tk.call('tk', 'accessible', 'get_acc_help', self._w)
+
+    def tk_add_acc_object(self):
+        """Register the widget with the platform accessibility API."""
+        self.tk.call('tk', 'accessible', 'add_acc_object', self._w)
+
+    def tk_emit_selection_change(self):
+        """Notify the platform accessibility API that the selection
+        in the widget has changed."""
+        self.tk.call('tk', 'accessible', 'emit_selection_change', self._w)
+
+    def tk_emit_focus_change(self):
+        """Notify the platform accessibility API that the widget has
+        received focus.
+
+        Not available on macOS."""
+        self.tk.call('tk', 'accessible', 'emit_focus_change', self._w)
+
     def wait_variable(self, name):
         """Wait until the variable is modified.
 
diff --git a/Misc/NEWS.d/next/Library/2026-07-06-14-38-02.gh-issue-145578.aX11yQ.rst b/Misc/NEWS.d/next/Library/2026-07-06-14-38-02.gh-issue-145578.aX11yQ.rst
new file mode 100644
index 00000000000000..8b2eda1d71eb31
--- /dev/null
+++ b/Misc/NEWS.d/next/Library/2026-07-06-14-38-02.gh-issue-145578.aX11yQ.rst
@@ -0,0 +1,9 @@
+Added :mod:`tkinter` support for the Tk 9.1 accessibility API: the
+``tk_set_acc_*`` and ``tk_get_acc_*`` families of methods which set and
+return the accessible attributes of a widget, the
+:meth:`~tkinter.Misc.tk_add_acc_object`,
+:meth:`~tkinter.Misc.tk_emit_selection_change` and
+:meth:`~tkinter.Misc.tk_emit_focus_change` methods which register custom
+widgets with the platform accessibility API, and the
+:meth:`~tkinter.Misc.tk_check_screenreader` method which reports whether a
+screen reader is running.