A poor fit between the physical design of the home and a resident’s functional ability can endanger the resident’s health and housing stability. This research used the Accessibility Module of the 2019 American Housing Survey (AHS) to understand national trends in housing fit, or the alignment between a resident’s needs and the home. A sizable share of households, especially among those with a resident with a disability, had at least one resident who experienced difficulty entering, getting around, or using the home. Commonly reported challenges included entering the home and using bedrooms, bathrooms, and kitchens. Housing fit tended to be worse for households with older residents as well as residents who were Black or Hispanic, or who lived with lower income. However, measures of resident satisfaction with housing did not always align with objective measures of housing fit, raising questions for future research about perception and decision-making. It was also unclear from these data which specific housing features impacted either housing fit or housing satisfaction. This research highlights the need for universal design, flexible design, and home modifications to improve housing fit, but it also raises questions that will be relevant to housing policy design.