Cheating at the Paralympic Games has caused scandals that have significantly changed the way in which the International Paralympic Committee (IPC) manages the events.

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Testing for performance-enhancing drugs has become increasingly strict and more widespread throughout the Games, with powerlifting seeing the most positive results. Competitors without disabilities have also competed in some Paralympic Games, with the Spanish entry in the intellectually disabled basketball tournament at the 2000 Summer Paralympics being the most notorious. It has been considered that intentionally misrepresenting a disability classification is as serious as drug use.^[1]

Concerns of athlete cheating by misrepresenting their classifications have been raised over time,^[2][3][4][5] by various other athletes including swimmer Jessica Long in 2016,^[6][7] and wheelchair racer Tanni Grey-Thompson in 2017.^[8] Intentional misrepresentation may provide a competitive advantage to athletes to improve chances of medal winning.^[9] In 2017, the International Paralympic Committee (IPC) defended their classification system as 'robust'.^[9]

At the Tokyo 2020 Paralympic Games, discus thrower Vinod Kumar was banned for two years after being found to have intentionally misrepresented his abilities.^[10][11]

In 2023, the former head of the IPC stated there were Paralympic athletes who deliberately exaggerated the level of the impairments.^[12] With a risk to Games credibility (and income), the IPC commenced reviewing their athlete classification code in 2021, which is expected to take three years.^[11] Both the Chair of the Para Badminton Athletes' Commission, and World Para Swimming classification advisor, indicated there was little chance of athletes getting sanctioned for intentional misrepresentation.^[11] In July 2023, one athlete launched a lawsuit against the IPC, that instead of just national and international sporting bodies, athletes would be able to challenge the classification of athletes believed to be mispresenting their impairments.^[13]

The first positive results came in the 1992 Barcelona Games with five athletes found to have used banned substances.^[14] The 2000 Sydney Games saw fourteen athletes return a positive test, ten of which were in the powerlifting competition.^[15]

The Paralympics have also been tainted by steroid use. At the 2008 Games in Beijing, three powerlifters and a German basketball player were banned after having tested positive for banned substances.^[16] This was a decrease in comparison to the ten powerlifters and one track athlete who were banned from the 2000 Games.^[17] German skier Thomas Oelsner became the first Winter Paralympian to test positive for steroids. He had won two gold medals at the 2002 Winter Paralympics, but his medals were stripped after his positive drug test.^[18] At the 2010 Winter Paralympics in Vancouver, Swedish curler Glenn Ikonen tested positive for a banned substance and was suspended for six months^[19] by the IPC. He was removed from the rest of the curling competition but his team was allowed to continue. The 54-year-old curler said his doctor had prescribed a medication on the banned substances list.^[20][21]

The Sydney 2000 Doping Control Program had the responsibility of ensuring that the games met the International Paralympic Medical and Anti-Doping Code and, for the first time in the sport, out-of-competition (OOC) testing was introduced. This meant that the testing window was much wider, with any competitor being called for a test at any point throughout the Games.

Nine powerlifters returned positive results before the competition and were promptly ejected. One further powerlifter and an athlete gave positive results after winning medals.^[15]

In the Salt Lake City Winter Paralympics in 2002 German cross country skier Thomas Oelsner gave a positive result after winning two gold medals. He was suspended for two years from all IPC events.^[22]

Another form of doping is "boosting", used by athletes with a spinal cord injury to induce autonomic dysreflexia and increase blood pressure. This was banned by the IPC in 1994 but is still an ongoing problem in the sport.^[23]

Another potential concern is the use of gene therapy among Paralympic athletes. All Paralympic athletes are banned from enhancing their abilities through gene doping, but it is extremely difficult to differentiate these concepts.^[24] The World Anti-Doping Agency is currently researching both gene doping and gene therapy, in part to discern the boundary between the two closely related concepts.^[25]

In the 1996 Atlanta Games athletes with intellectual disabilities were allowed to participate for the first time with full medal status.^[29]

• Controversies at the 2012 Summer Paralympics
• "Up the Down Steroid," an episode of South Park with a subplot about Eric Cartman pretending to be intellectually impaired
• The Ringer, a comedy film about a man pretending to be developmentally disabled to compete in the Special Olympics