The design of custom contoured cushions manufactured in flexible polyurethane foams is an option to improve positioning and comfort for people with disabilities that spend most of the day seated in the same position. These surfaces increase the contact area between the seat and the user. This fact contributes to minimise the local pressures that can generate problems like decubitus ulcers. The present research aims at establishing development routes for custom cushion production to wheelchair users. This study also contributes to the investigation of Computer Numerical Control (CNC) machining of flexible polyurethane foams.The proposed route to obtain the customised seat began with acquiring the user's contour in adequate posture through plaster cast. To collect the surface geometry, the cast was three-dimensionally scanned and manipulated in CAD/CAM software. CNC milling parameters such as tools, spindle speeds and feed rates to machine flexible polyurethane foams were tested. These parameters were analysed regarding the surface quality. The best parameters were then tested in a customised seat. The possible dimensional changes generated during foam cutting were analysed through 3D scanning. Also, the customised seat pressure and temperature distribution was tested.The best parameters found for foams with a density of 50kg/cm(3) were high spindle speeds (24000 rpm) and feed rates between 2400-4000mm/min. Those parameters did not generate significant deformities in the machined cushions. The custom contoured cushion satisfactorily increased the contact area between wheelchair and user, as it distributed pressure and heat evenly.Through this study it was possible to define routes for the development and manufacturing of customised seats using direct CNC milling in flexible polyurethane foams. It also showed that custom contoured cushions efficiently distribute pressure and temperature, which is believed to minimise tissue lesions such as pressure ulcers.