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Objectives: Children with disabilities need assistive technology (AT) to explore their surroundings, participate in social activities, and gain developmental skills. This study aimed to assess AT needs and barriers to access it for these children. Methods: The study participants comprised 217 children with disabilities aged 6-12 years, randomly selected from the registration list of Chaharmahal and Bakhtiari Welfare Organization, Chaharmahal and Bakhtiari Province, Iran, in 2022. After obtaining informed consent from their parents, study data were gathered by phone interview using the rapid assessment of AT (rATA) tool of the World Health Organization (WHO). Results: Among the 217 participants, 108(49.8%) used AT devices, and 102(47%) had unmet needs. Of the 55 AT devices named in the rATA, only 14 were used by the children. The most commonly used devices were hearing aids, glasses, and wheelchairs. Unmet needs of ‘chairs for bath/toilet,’ ‘wheelchairs,’ and ‘therapeutic footwear’ accounted for 50% of 132 unmet AT needs. The most common reasons for lacking AT were lack of financial resources (52%) and knowledge about AT devices (30.1%). Most clients were satisfied with AT-use training (92.3%), but only 20.2% were satisfied with AT device repair services. Discussion: This study highlights the need to improve AT device repair services, overcome financial challenges, and increase parental knowledge about AT devices as the most prevalent barriers to using AT devices. Developing a child-specific version of the rATA tool that includes questions about education and play engagement AT needs is suggested for better estimation of AT needs for children with disabilities in the future.