diff --git a/src/browser/AccessibilityManager.ts b/src/browser/AccessibilityManager.ts
index 42242fef1c..0a2cbf239c 100644
--- a/src/browser/AccessibilityManager.ts
+++ b/src/browser/AccessibilityManager.ts
@@ -8,16 +8,32 @@ import { ITerminal, IRenderDebouncer } from 'browser/Types';
 import { isMac } from 'common/Platform';
 import { TimeBasedDebouncer } from 'browser/TimeBasedDebouncer';
 import { Disposable, toDisposable } from 'common/Lifecycle';
+import { ScreenDprMonitor } from 'browser/ScreenDprMonitor';
+import { IRenderService } from 'browser/services/Services';
+import { addDisposableDomListener } from 'browser/Lifecycle';
 
 const MAX_ROWS_TO_READ = 20;
 
+const enum BoundaryPosition {
+  TOP,
+  BOTTOM
+}
+
 export class AccessibilityManager extends Disposable {
   private _accessibilityContainer: HTMLElement;
 
+  private _rowContainer: HTMLElement;
+  private _rowElements: HTMLElement[];
+
   private _liveRegion: HTMLElement;
   private _liveRegionLineCount: number = 0;
   private _liveRegionDebouncer: IRenderDebouncer;
 
+  private _screenDprMonitor: ScreenDprMonitor;
+
+  private _topBoundaryFocusListener: (e: FocusEvent) => void;
+  private _bottomBoundaryFocusListener: (e: FocusEvent) => void;
+
   /**
    * This queue has a character pushed to it for keys that are pressed, if the
    * next character added to the terminal is equal to the key char then it is
@@ -32,12 +48,30 @@ export class AccessibilityManager extends Disposable {
   private _charsToAnnounce: string = '';
 
   constructor(
-    private readonly _terminal: ITerminal
+    private readonly _terminal: ITerminal,
+    @IRenderService private readonly _renderService: IRenderService
   ) {
     super();
     this._accessibilityContainer = document.createElement('div');
     this._accessibilityContainer.classList.add('xterm-accessibility');
 
+    this._rowContainer = document.createElement('div');
+    this._rowContainer.setAttribute('role', 'list');
+    this._rowContainer.classList.add('xterm-accessibility-tree');
+    this._rowElements = [];
+    for (let i = 0; i < this._terminal.rows; i++) {
+      this._rowElements[i] = this._createAccessibilityTreeNode();
+      this._rowContainer.appendChild(this._rowElements[i]);
+    }
+
+    this._topBoundaryFocusListener = e => this._handleBoundaryFocus(e, BoundaryPosition.TOP);
+    this._bottomBoundaryFocusListener = e => this._handleBoundaryFocus(e, BoundaryPosition.BOTTOM);
+    this._rowElements[0].addEventListener('focus', this._topBoundaryFocusListener);
+    this._rowElements[this._rowElements.length - 1].addEventListener('focus', this._bottomBoundaryFocusListener);
+
+    this._refreshRowsDimensions();
+    this._accessibilityContainer.appendChild(this._rowContainer);
+
     this._liveRegion = document.createElement('div');
     this._liveRegion.classList.add('live-region');
     this._liveRegion.setAttribute('aria-live', 'assertive');
@@ -50,6 +84,7 @@ export class AccessibilityManager extends Disposable {
     this._terminal.element.insertAdjacentElement('afterbegin', this._accessibilityContainer);
 
     this.register(this._liveRegionDebouncer);
+    this.register(this._terminal.onResize(e => this._handleResize(e.rows)));
     this.register(this._terminal.onRender(e => this._refreshRows(e.start, e.end)));
     this.register(this._terminal.onScroll(() => this._refreshRows()));
     // Line feed is an issue as the prompt won't be read out after a command is run
@@ -58,7 +93,20 @@ export class AccessibilityManager extends Disposable {
     this.register(this._terminal.onA11yTab(spaceCount => this._handleTab(spaceCount)));
     this.register(this._terminal.onKey(e => this._handleKey(e.key)));
     this.register(this._terminal.onBlur(() => this._clearLiveRegion()));
-    this.register(toDisposable(() => this._accessibilityContainer.remove()));
+    this.register(this._renderService.onDimensionsChange(() => this._refreshRowsDimensions()));
+
+    this._screenDprMonitor = new ScreenDprMonitor(window);
+    this.register(this._screenDprMonitor);
+    this._screenDprMonitor.setListener(() => this._refreshRowsDimensions());
+    // This shouldn't be needed on modern browsers but is present in case the
+    // media query that drives the ScreenDprMonitor isn't supported
+    this.register(addDisposableDomListener(window, 'resize', () => this._refreshRowsDimensions()));
+
+    this._refreshRows();
+    this.register(toDisposable(() => {
+      this._accessibilityContainer.remove();
+      this._rowElements.length = 0;
+    }));
   }
 
   private _handleTab(spaceCount: number): void {
@@ -126,4 +174,107 @@ export class AccessibilityManager extends Disposable {
     this._liveRegion.textContent += this._charsToAnnounce;
     this._charsToAnnounce = '';
   }
+
+  private _handleBoundaryFocus(e: FocusEvent, position: BoundaryPosition): void {
+    const boundaryElement = e.target as HTMLElement;
+    const beforeBoundaryElement = this._rowElements[position === BoundaryPosition.TOP ? 1 : this._rowElements.length - 2];
+
+    // Don't scroll if the buffer top has reached the end in that direction
+    const posInSet = boundaryElement.getAttribute('aria-posinset');
+    const lastRowPos = position === BoundaryPosition.TOP ? '1' : `${this._terminal.buffer.lines.length}`;
+    if (posInSet === lastRowPos) {
+      return;
+    }
+
+    // Don't scroll when the last focused item was not the second row (focus is going the other
+    // direction)
+    if (e.relatedTarget !== beforeBoundaryElement) {
+      return;
+    }
+
+    // Remove old boundary element from array
+    let topBoundaryElement: HTMLElement;
+    let bottomBoundaryElement: HTMLElement;
+    if (position === BoundaryPosition.TOP) {
+      topBoundaryElement = boundaryElement;
+      bottomBoundaryElement = this._rowElements.pop()!;
+      this._rowContainer.removeChild(bottomBoundaryElement);
+    } else {
+      topBoundaryElement = this._rowElements.shift()!;
+      bottomBoundaryElement = boundaryElement;
+      this._rowContainer.removeChild(topBoundaryElement);
+    }
+
+    // Remove listeners from old boundary elements
+    topBoundaryElement.removeEventListener('focus', this._topBoundaryFocusListener);
+    bottomBoundaryElement.removeEventListener('focus', this._bottomBoundaryFocusListener);
+
+    // Add new element to array/DOM
+    if (position === BoundaryPosition.TOP) {
+      const newElement = this._createAccessibilityTreeNode();
+      this._rowElements.unshift(newElement);
+      this._rowContainer.insertAdjacentElement('afterbegin', newElement);
+    } else {
+      const newElement = this._createAccessibilityTreeNode();
+      this._rowElements.push(newElement);
+      this._rowContainer.appendChild(newElement);
+    }
+
+    // Add listeners to new boundary elements
+    this._rowElements[0].addEventListener('focus', this._topBoundaryFocusListener);
+    this._rowElements[this._rowElements.length - 1].addEventListener('focus', this._bottomBoundaryFocusListener);
+
+    // Scroll up
+    this._terminal.scrollLines(position === BoundaryPosition.TOP ? -1 : 1);
+
+    // Focus new boundary before element
+    this._rowElements[position === BoundaryPosition.TOP ? 1 : this._rowElements.length - 2].focus();
+
+    // Prevent the standard behavior
+    e.preventDefault();
+    e.stopImmediatePropagation();
+  }
+
+  private _handleResize(rows: number): void {
+    // Remove bottom boundary listener
+    this._rowElements[this._rowElements.length - 1].removeEventListener('focus', this._bottomBoundaryFocusListener);
+
+    // Grow rows as required
+    for (let i = this._rowContainer.children.length; i < this._terminal.rows; i++) {
+      this._rowElements[i] = this._createAccessibilityTreeNode();
+      this._rowContainer.appendChild(this._rowElements[i]);
+    }
+    // Shrink rows as required
+    while (this._rowElements.length > rows) {
+      this._rowContainer.removeChild(this._rowElements.pop()!);
+    }
+
+    // Add bottom boundary listener
+    this._rowElements[this._rowElements.length - 1].addEventListener('focus', this._bottomBoundaryFocusListener);
+
+    this._refreshRowsDimensions();
+  }
+
+  private _createAccessibilityTreeNode(): HTMLElement {
+    const element = document.createElement('div');
+    element.setAttribute('role', 'listitem');
+    element.tabIndex = -1;
+    this._refreshRowDimensions(element);
+    return element;
+  }
+  private _refreshRowsDimensions(): void {
+    if (!this._renderService.dimensions.css.cell.height) {
+      return;
+    }
+    this._accessibilityContainer.style.width = `${this._renderService.dimensions.css.canvas.width}px`;
+    if (this._rowElements.length !== this._terminal.rows) {
+      this._handleResize(this._terminal.rows);
+    }
+    for (let i = 0; i < this._terminal.rows; i++) {
+      this._refreshRowDimensions(this._rowElements[i]);
+    }
+  }
+  private _refreshRowDimensions(element: HTMLElement): void {
+    element.style.height = `${this._renderService.dimensions.css.cell.height}px`;
+  }
 }