More students with disabilities are accessing the tertiary sector with many disabilities not easily observed (or hidden), because there are no physical indicators. These “hidden” disabilities affect a variety of cognitive processes and may be developmental or acquired. To ensure students with hidden disabilities can enrol, engage in and benefit from tertiary education, universities generally provide a range of supports. Typically these supports and any reasonable adjustments are negotiated with students taking into account a number of factors including, where available, any supporting documentation that they might be able to provide. This case study reports efforts within one large Australian university to support higher education students with hidden disabilities on campus. Perceptions on the use of and barriers to support available were collected from seven undergraduate students who self-identified as having hidden disabilities and from eight support staff. Results indicated that students found their informal networks to be their most effective supports, closely followed by clear, caring and flexible lecturers and tutors. There were mixed positive and negative perceptions reported on the universal and disability-specific supports available. Implications and future research directions are discussed.