To describe the characteristics of the wheelchairs, the users, and their wheelchair use among persons newly prescribed a manual wheelchair. Cohort study. Veterans Affairs teaching hospital. Ninety-nine consecutive, cognitively intact veterans prescribed a manual wheelchair. Not applicable. Self-reported difficulty transferring into and propelling the wheelchair; and bathroom mobility method. Study patients had a mean age of 66 and a mean of 10 comorbid medical conditions. Parkinsonism, osteoporosis, joint replacement, and amputation were uncommon (<30% of patients), but had a high impact on need for a wheelchair (when present were reported by >50% of patients as causing need for a wheelchair). Falls and arthritis were common (>50% of patients) and highly impacted need for a wheelchair. At 1 month, over 30% of patients had wheelchairs that did not meet common criteria for wheelchair fit; 36% and 61%, respectively, reported difficulty transferring and propelling the wheelchair. The wheelchairs were used for bathroom mobility by 38% of the patients. The typical manual wheelchair recipient in this study sample was old with multiple medical problems. Despite provision of manual wheelchairs by trained professionals and availability of diverse wheelchair types, new wheelchair users commonly reported difficulty using the wheelchair.