Mathematical Equations and accessible documents are a major hurdle in the creation of accessible content. Guidance and best practices advocate for equations to be written in MathML for the greatest accessibility, however displaying MathML has not been implemented in most modern internet browsers or software systems. This has created a confusing system where math is often entered in one format, displayed in a second, and made available to assistive technology in a third. This presentation will be a deep dive into the world of presentation languages (MathML, LaTeX), the conversion tools we use to translate and their limitations (KaTeX, MathJax, MathType) and authoring tools for faculty (Equatio, MathType, Microsoft Equation Editor). Many of these solutions have strengths and limitations which we will present so that attendees can evaluate new solutions as they become available.