Occupational therapists have been exploring and debating the therapeutic use of computers for over 10 years. Much of the literature on this topic is descriptive in nature. There has, however, been some work done in the area of cognitive rehabilitation. This article reviews the literature in relation to the use of computers in occupational therapy and in computer-assisted cognitive rehabilitation (CACR). The benefits of computers and the human computer interface are explored and the restorative versus the adaptive approaches in cognitive rehabilitation are debated. The role of occupational therapy in CACR is discussed and assistive technology literature is used to expand upon this topic. The topic of the contributions of programmers and clinicians in designing software is raised. Software issues are also raised, such as the properties, limitations and development of software. The conclusions suggest that there have been few studies that have explored the efficacy of CACR and that those that have indicate that there is limited clinical benefit. Some of the limiting factors are the hardware the programs were developed on and the lack of theoretical underpinning for using software in a rehabilitation programme. However, when an adaptive rather than a restorative approach is considered, the use of computers in this area appears more promising.