Being able to access software in daily life is vital for everyone, and thus accessibility is a fundamental challenge for software development. However, given the number of accessibility issues reported by many users, e.g., in app reviews, it is not clear if accessibility is widely integrated into current software projects and how software projects address accessibility issues. In this article, we report a study of the critical challenges and benefits of incorporating accessibility into software development and design. We applied a mixed qualitative and quantitative approach for gathering data from 15 interviews and 365 survey respondents from 26 countries across five continents to understand how practitioners perceive accessibility development and design in practice. We got 44 statements grouped into eight topics on accessibility from practitioners’ viewpoints and different software development stages. Our statistical analysis reveals substantial gaps between groups, e.g., practitioners have Direct vs. Indirect accessibility relevant work experience when they reviewed the summarized statements. These gaps might hinder the quality of accessibility development and design, and we use our findings to establish a set of guidelines to help practitioners be aware of accessibility challenges and benefit factors. We suggest development teams put accessibility as a first-class consideration throughout the software development process, and we also propose some remedies to resolve the gaps between groups and to highlight key future research directions to incorporate accessibility into software design and development.