The opportunity to realistically equip the ventilator-dependent tetraplegic to return to his community can be met by a concerned team in specialised spinal cord injury centres. Proper equipment, independent electric wheelchair mobility and family training, encourages acceptance of the ventilator-dependent quadriplegic and increases his life-style options. Ideally, the initial 6-month medical management and rehabilitation programme is followed by periodic re-evaluations for medical follow-up, equipment changes and functional upgrading. The medical community must continue to respond to the challenge to offer adequate living facilities and financial resources for equipment and programme development.