The outdoor environment can provide many positive and therapeutic benefits for persons with complex neurological conditions. In order to benefit from outdoor exposure and experiences, individuals need to be able to access that environment. This article provides a discussion of physical and programmatic access to outdoor living elements in homes and residential facilities for persons with neuro-disabilities. Design considerations for outdoor elements such as common gathering areas, walking paths and paths to/between elements, gardens (viewing and working), and resting areas are presented using legal standards or universal design principles as guides.