This chapter examines the role that adult guardianship plays as one of the principal means by which legal decision-making authority can be removed from a person. The chapter considers the grounds for adult guardianship appointments, and discusses the types of decisions that guardians can make, which include accommodation and medical treatment decisions. The chapter also considers the interaction between guardianship laws and the provision of disability support. State and federal law reform commissions have reviewed Australian adult guardianship laws in recent years, and adult guardianship laws worldwide are the subject of debate over their consistency with international human rights norms. This chapter considers these reviews and critiques, and identifies the possible and the likely ways in which Australia’s guardianship laws might be reformed.