the game is now accessible with the use of mods and the topic is being updated with links to reflect the situation of the game, i'll past the description of the game bellow, plus the link to reddit's original topic that got attention from the community:
for those who don't want to install steam, looks like gog has the game to download in an accessible and drm free formate. there's a complete accessible package to use with it, it is being maintaned and updated by the user @firefly82.
find the gog package here:
https://www.dropbox.com/s/9vtpjw50tvbkx … re.7z?dl=1
buy the game on gog drm free here:
https://www.gog.com/game/slay_the_spire
Description:
We fused card games and roguelikes together to make the best single player deckbuilder we could. Craft a unique deck, encounter bizarre creatures, discover relics
of immense power, and Slay the Spire!

Features:
?Dynamic Deck Building: Choose your cards wisely! Discover hundreds of cards to add to your deck with each attempt at climbing the Spire. Select cards that work
together to efficiently dispatch foes and reach the top.
?An Ever-changing Spire: Whenever you embark on a journey up the Spire, the layout differs each time. Choose a risky or safe path, face different enemies, choose
different cards, discover different relics, and even fight different bosses!
?Powerful Relics to Discover: Powerful items known as relics can be found throughout the Spire. The effects of these relics can greatly enhance your deck through
powerful interactions. But beware, obtaining a relic may cost you more than just gold...

?Three core characters that each have their own unique set of cards.
?250+ fully implemented cards.
?150+ different items to be found.
?50+ unique combat encounters.
?50+ mysterious events that can help or harm you.
?Daily Climbs allow you to compare yourself with every other player in the world.
?Custom mode that allows mixing and matching various crazy run modifiers.
here's the reddit topic:
https://www.reddit.com/r/slaythespire/c … the_spire/
edit:
a user posted on reddit that he made a mod so his girl who's completely blind could play it at the start of quarantine. she spent more than 450 hours playing the game and it's fully accessible with this mod, it's pretty self explanatory with the readme, but if you have any questions, just ask and i'll do my best to help!
https://github.com/Wensber/TextTheSpire
edit 2:
@pitermach developed a program to interact with text the spire which takes the mod to the next level, it works even with sapi, if you don't have a screen reader running.
you can interact with the mod by using alt and arrow keys, alt home and end to go to the start and end of the buffer, or alt c to copy stuff to the keyboard. this way you can simply focus the prompt window and play without switching windows or interruptions.
get the mod here
https://github.com/pitermach/ReadTheSpire/releases
lastly, here's the readme copied from text the spire, so you have links to everything to get started and play the game
TextTheSpire
Author: Wensber - [email protected]
https://steamcommunity.com/sharedfiles/ … 2130936088 https://github.com/Wensber/TextTheSpire
Description:
This is a mod for the game Slay the Spire and provides screen reader accessibility. It does so by providing lots of windows displaying the game information and a prompt window for inputting commands. Descriptions of the windows and commands are provided with the help command.
Limitations:
TextTheSpire is currently not capable of accessing various menus or screens. This includes save slots, statistics, achievements, compendium, run history, settings, patch notes, custom game, etc. Daily Climb is supported but the Modifiers Draft and Sealed Deck are not yet.
Requirements:
Steam - https://steamcommunity.com/
Slay the Spire - https://store.steampowered.com/app/6465 … the_Spire/
Java - https://www.oracle.com/java/technologie … loads.html
Text the Spire - https://steamcommunity.com/sharedfiles/ … 2130936088
CommunicationMod - https://steamcommunity.com/sharedfiles/ … 2131373661
BaseMod - https://steamcommunity.com/workshop/fil … 1605833019
ModTheSpire - https://steamcommunity.com/sharedfiles/ … 1605060445
If you don't already have a screen reader, you can NVDA for free from https://www.nvaccess.org/
Recommendations:
Read the Spire, mod that can auto read changes in windows: https://github.com/pitermach/ReadTheSpire
Mod to enable achievements: https://steamcommunity.com/sharedfiles/ … 1692554109
Gameplay mechanics guide: https://slay-the-spire.fandom.com/wiki/Gameplay
Installation:
Note: This guide is for the steam version of the game.
Step 1:
If you have not yet, install Steam, create an account, and install Java.
Step 2:
Download Slay the Spire from the Steam webpage. You do not need to do so through the Steam client which is harder for screen readers. Subscribe to both BaseMod and ModTheSpire.
Step 3:
Find the Slay the Spire directory. In Windows the directory path should be similar to C/Program Files x 86/Steam/steamapps/common/SlayTheSpire.
Step 4:
Create a shortcut of the file mts-launder.jar on your desktop. This is how you will start the game.
Step 5:
Double click mts-launder to launch the mod. The first time you will need to select the mods. There is a select all option on the Mod the Spire window that will show up. Afterwards they will be auto selected. Hit enter to start the game. One more step.
Step 6:
You will need to set a save file name if you don't have a save file yet. Output should mention this as well. Go to the main Slay the Spire window, type your name, and hit enter. You are now free to play the game. Type help in the prompt to read about controls.