Abstract Artificial Intelligence (AI) technologies offer the potential to reduce barriers to communication and facilitate greater participation of Deaf and Hard of Hearing (DHH) and disabled communities in society. However, there is a risk that such technologies could have a disproportionately negative impact on these communities and exacerbate existing social inequities. In this narrative review, we examine key ethical issues surrounding AI use in the context of DHH and disabled communities. These include issues related to bias, accessibility, equity and privacy, and others. We propose a grounded, co-constructed participatory approach that focuses on the ethical co-development of these technologies through the active involvement of DHH and disabled individuals in interdisciplinary research. This inclusive approach is imperative to tailor AI solutions to the unique perspectives and experiences of DHH and disabled individuals and ensure they reduce, rather than perpetuate, societal barriers experienced by these minority groups.