OBJECTIVE:The goal was to develop an objective, comprehensive, near-task home lighting assessment for older adults with low vision. METHOD:A home lighting assessment was developed and tested with older adults with low vision. Interrater and test-retest reliability studies were conducted. Clinical utility was assessed by occupational therapists with expertise in low vision rehabilitation. RESULTS:Interrater reliability was high (intraclass correlation coefficient [ICC] = .83-1.0). Test-retest reliability was moderate (ICC = .67). Responses to a Clinical Utility Feedback Form developed for this study indicated that the Home Environment Lighting Assessment (HELA) has strong clinical utility. CONCLUSION:The HELA provides a structured tool to describe the quantitative and qualitative aspects of home lighting environments where near tasks are performed and can be used to plan lighting interventions. The HELA has the potential to affect assessment and intervention practices of rehabilitation professionals in the area of low vision and improve near-task performance of people with low vision.