Video game accessibility is no longer a peripheral concern but a core requirement for equitable participation in digital play. This paper proposes a three-dimensional theoretical framework—physical, cognitive, and socio-emotional—that unifies disability-studies theory, user-generated evidence from Can I Play That?, and quantitative market data from Newzoo. A mixed-methods pipeline first scraped and embedded 2019–2024 CIPT reviews, producing six thematic clusters (Controls, UI & Navigation, Audio, Difficulty, Visual Accessibility, Subtitles). These user-level insights were then triangulated with Newzoo’s global reports to reveal how accessible features correlate with broader audience reach and revenue potential. By illustrating both ethical imperatives and commercial gains, the framework provides developers, researchers, and publishers with actionable guidance for embedding accessibility from concept to post-launch. Ultimately, universal design in gaming is demonstrated to be both a moral and strategic imperative.