For decades now, as the issue of social progress has come to the fore, the drive to improve access to education has been behind the growth in research into e-learning. The current systematic literature review raised the question of the existence of studies addressing the specific needs of persons with cognitive impairments. Indeed, e-learning is expected to be one of the critical tools for improving access to education and ultimately aiding social inclusion. The systematic literature review was performed through a four-step process including an exhaustive search of scientific literature databases, the selection of studies through exclusion and inclusion criteria, and literature analysis and synthesis. The main results are: 1) a lack of e-learning studies addressing the issue of accessibility for people with cognitive impairments (N = 29) with a purpose dominated by design guidelines rather than effectiveness assessment; 2) a weak inclusion of accessibility standards (N = 5) and 3) a weak inclusion of special education findings (N = 3), with a focus on specific neuropsychological disorders or syndromes (dyslexia, ADHD, etc.) rather than on impairments of cognitive function (attention, memory, etc.) as promoted by the International Classification of Functioning (World Health Organization, 2001); 4) the identification of five families of accessibility function (adaptive systems, game elements, accessible content, virtual agents and accessible interfaces or environments) and their dependency with activity-domain of learning. Results are discussed in terms of both design and assessment recommendations, promoting a multi-disciplinary approach combining educational sciences, cognitive sciences and computer science to develop more accessible e-learning systems.