Good News: You’ve Already Done the Hard Work
If you’ve already prepared an accessible Word document following the steps in our companion guide — using proper heading styles, adding alt text to images, structuring tables correctly, and running the Accessibility Checker — then creating an accessible PDF is mostly a matter of exporting the file the right way. The structural work you did in Word carries directly into the PDF.
PDFs that are “accessible” in a meaningful sense are not just readable on screen — they contain an underlying structure (called a “tag tree”) that tells assistive technologies like screen readers what each piece of content is: a heading, a paragraph, a list item, an image with a description, and so on. When you export a well-structured Word document to PDF correctly, Word builds that tag tree for you automatically.
The key principle: Accessibility in a PDF starts in the source document. A PDF exported from a poorly structured Word file will require significant manual remediation in Adobe Acrobat. A PDF exported from a well-structured Word file will be largely accessible out of the box.
Step 1: Export to PDF the Right Way
Not all PDF export methods preserve the document’s accessibility structure. The method you use matters.
The Right Way: Save As or Export
✅ Windows: File → Save As → choose PDF from the format dropdown. Before saving, click “More options” → “Options” and make sure “Document structure tags for accessibility” is checked.
✅ Mac: File → Save As → choose PDF, or File → Export → PDF. In the export dialog, select “Best for electronic distribution and accessibility.”
What to Avoid
❌ Don’t use “Print to PDF.” This creates a flat image-like PDF with no tag structure — it is essentially inaccessible. Screen readers cannot read it, and search engines cannot index it.
❌ Don’t use third-party PDF printers (such as CutePDF or similar) unless you are certain they support tagged PDF output. Most do not.
Also available via Adobe Acrobat: If you have Adobe Acrobat installed, you can use the Acrobat tab in Word’s ribbon to export directly. Use “Create PDF” from that tab rather than Word’s own Save As for the most reliable results, as the Acrobat add-in is specifically designed to produce well-tagged PDFs from Office documents.
Step 2: Set Document Properties
Before or after exporting, make sure the PDF has meaningful document properties. These are read by screen readers when a user opens the file and are also used by search engines and citation tools.
In Adobe Acrobat, go to File → Properties (or Ctrl+D / Cmd+D). On the “Description” tab, fill in at minimum:
Title — the full article title (not the filename).
Author — the author(s) of the article.
Subject — a brief description or the journal name.
Keywords — relevant subject terms.
Also on the “Advanced” tab, confirm that the “Language” field is set correctly (e.g., “en-US” for English). Screen readers use this to select the correct pronunciation rules.
Set the title in Word too: You can set the document title before exporting by going to File → Info → Properties (in the right-hand panel) and entering the title there. Word will carry it into the exported PDF automatically.
Step 3: Run the Acrobat Accessibility Checker
Adobe Acrobat (Pro or Standard) includes a built-in Accessibility Checker that scans a PDF for compliance with accessibility standards. Running it after export is a good final quality check, even for PDFs generated from well-structured Word documents.
Running the Full Accessibility Check
1. Open the PDF in Adobe Acrobat.
2. Go to All Tools (the grid icon in the left panel) → Prepare for accessibility, or navigate via the menu: View → Tools → Accessibility.
3. Click “Check for accessibility.” A dialog will appear where you can choose which checks to run. The defaults are appropriate for most documents.
4. Click “Start Checking.” Acrobat will analyze the document and display the results in the Accessibility Checker panel.
Results are grouped by category (Document, Page Content, Forms, Tables, Lists, Headings, etc.) and marked as Passed, Failed, Skipped, or Needs Manual Check. Click any failed item to jump to the relevant part of the document and see a description of the problem.
Common Issues and How to Address Them
Here are the most common issues that appear in the Accessibility Checker for PDFs exported from Word, and what to do about them:
Document is not tagged
This means the PDF has no tag structure at all. It almost always means the file was exported using Print to PDF or a method that does not support tagging. The fix is to re-export from the Word source using Save As → PDF with tagging enabled.
Title is missing
The PDF’s document title property is empty or has not been set to display the title (as opposed to the filename). Fix this in File → Properties → Description tab, then check the “Show document title” option in the Initial View tab.
Figures alternate text is missing or failed
One or more images lack alt text. If this was overlooked in the Word document, you can add alt text directly in Acrobat: right-click the image → Edit Alternate Text (in older Acrobat versions, use the Reading Order tool or the Tags panel to locate the figure tag and add a description).
Tab order may not be consistent with structure
This warning means the order in which keyboard users tab through the document may not match the visual reading order. Fix it in Acrobat via Page Thumbnails: right-click the page thumbnail → Page Properties → Tab Order → select “Use Document Structure.”
Headings: appropriate nesting failed
Heading levels are skipped (e.g., jumping from H1 directly to H3). This usually reflects the same issue in the Word source document. Correct the heading structure in Word and re-export; or, if only minor fixes are needed, use the Tags panel in Acrobat to adjust the heading tags directly.
Advanced: Reading Order and the Tags Panel
For most straightforward journal articles exported from a well-structured Word document, the Accessibility Checker and a few quick fixes will be sufficient. However, if an article has a complex layout — multiple columns, figures with captions, sidebars, or complex tables — you may need to use two additional tools in Acrobat to verify and correct the accessibility structure.
The Reading Order Tool
The Reading Order tool (found in the Accessibility tools panel) shows the order in which a screen reader will read the content on each page. Content is displayed as numbered, colored blocks. Check that the reading order matches the logical flow of the article — left to right, top to bottom for a standard single-column layout.
If blocks are out of order (for example, a caption is read before its figure, or a sidebar interrupts the main text), you can drag them into the correct sequence within the Reading Order tool.
The Tags Panel
The Tags panel (View → Show/Hide → Navigation Panes → Tags) displays the full tag tree of the document — the underlying structure that assistive technologies use. It is the most powerful tool for PDF accessibility but also the most technical. Common uses include:
Verifying that heading tags (H1, H2, H3) are present and correctly nested.
Adding or editing alt text on figure tags.
Correcting table tags when the Accessibility Checker reports table issues.
Marking decorative elements (such as page borders or background images) as “Artifact” so screen readers skip them.
Note: For articles with straightforward layouts, you are unlikely to need the Tags panel. Focus on getting the Word document right and using the Accessibility Checker first. The Tags panel is a fallback for complex or legacy documents.
A Note on Standards: PDF/UA
PDF/UA (ISO 14289) is the international standard for universally accessible PDFs. A PDF that meets PDF/UA is considered fully accessible under most regulatory frameworks, including WCAG 2.x and Section 508.
Acrobat’s Accessibility Checker includes a “PDF/UA” section in its results. For most journal articles exported from a well-structured Word document, passing the PDF/UA checks is achievable with modest effort. The most common barrier is ensuring all figures have meaningful alt text.
You do not need to target PDF/UA compliance immediately, but it is a useful benchmark to work toward as your accessibility practices mature.
Further Resources
Adobe: Create and verify PDF accessibility (Acrobat Pro) — Adobe’s official guide to the Accessibility Checker and tagging tools.
PDF/UA Foundation — overview of the PDF/UA standard and resources for implementers.
WebAIM: PDF Accessibility — a practical, plain-language guide to making PDFs accessible.
Microsoft Support: Save a Word document as a PDF — step-by-step export instructions for Windows and Mac.
Related Guide
The best foundation for an accessible PDF is an accessible Word document. See Publishing Accessible HTML Articles Using the Pandoc Plugin for guidance on preparing a Word document with the correct structure, including heading styles, alt text, lists, and tables — all of which carry through directly into your PDF export.