ABSTRACT: Participation in sailing by people with disabilities, particularly in small sailboats, is widely regarded as having positive outcomes on self-esteem and general health for the participants. However, a major hurdle for people with no previous experience of sailing, even by those without disabilities, is the perception that sailing is elitist, expensive, and dangerous. Real-time “ride-on” sailing simulators have the potential to bridge the gap between dry-land and on-the-water sailing. These provide a realistic, safe, and easily supervised medium in which nonsailors can easily and systematically learn the required skills before venturing out on the water. The authors report a 12-wk pilot therapeutic sailing program using the VSail-Access sailing simulation system followed by on-water experience. After completion of the training, all subjects demonstrated the ability to navigate a simple course around marker buoys (triangular configuration) on the computer screen, the ability to sail independently in winds of moderate strength (up to 14 knots) on water, and measurable improvements in their psychologic health. In addition, the subjects were able to participate in a sports activity with their respective family members and experienced a sense of optimism about their future.