Las Vegas is without question one of the easiest tourist desintations to visit on wheels, but since most of the hot spots have been built within the last decade and they are intended for visitors, I have very high standards for accessibility. There is no reason that new architecture should not be fully and conveniently accessible.
If you do a search for "accessibility Las Vegas" on most search engines, you will find a few pages whose writers assure you that it is no problem to visit as a tourist with wheels. After my first wheeled sojourn, I can report that overall it is quite possible and enjoyable, but it is truly more of a challenge to visit Las Vegas on wheels than to visit it on feet. A little preparation and some intestinal fortitude can really pay off.
McCarran airport, as with most airports, is possessed of corridors wide enough to accommodate my scooter. The tram from the United terminal to the is navigable, but be careful if the tramcar is full! Because the cars have floor-to-ceiling poles for passengers to hold, a wheelchair/scooter passenger must either park themselves in the middle of the aisle or in front of a door. Either can lead to being leaned on or bumped into. Also, I immediately gave up on the idea exiting through the door opposite the one through which I had entered, and instead positioned myself to exit through the next door ahead of me. This is a good strategy for subways/trams in general, but can confuse one's nonwheeled companions, as they will be accustomed to leaving through the counterpart to the entry door. The elevators at McCarran have a lot of signs announcing that there ARE elevators: this is different from elevators being "well-marked." Keep your head up and look for shiny doors. The elevators themselves are of an excellent size.
Each taxi company in Las Vegas is required to have a couple of wheelchair-accessible vehicles. If you are able to get out of your chair, there are also a great many vans and Ford Explorers that can hold the mobility equipment in the cargo area. In three days, I ran into only one cabbie who did not want to "deal with it." Aside from this brute, I found the cabbies very professional and willing to help my husband lift my scooter into their vehicles. However, nothing beats a taxi equipped with a lift...if you can plan a few minutes ahead and have the taxi valet at your hotel call for one of these, I absolutely recommend it. The lift changes the pleasant taxi experience from a bit of a gamble to a sure thing.
The Las Vegas Hilton is well-equipped with completely accessible rooms, but I try to stay in regular rooms, leaving the others available to guests who have greater mobility problems than I do. If you stay in a standard room at this Hilton with a scooter/wheelchair, I recommend a room with one king bed. This configuration has a great deal of floor space in which to zoom around. It is possible to get a scooter into the two queen bed room (where my parents stayed) but it necessary to park somewhere by the wall, as the second bed is taking up a majority of zooming-space. The elevator in this Hilton are just fine and the layout of the casino is very nice; the ramps are in plain sight and most of the slot machines have unattached seating, so it is possible to scootch the casino's chair out of the way to wheel up to them.
The Venetian is another matter. The best way I can describe it is to say that the property's two parts, hotel and casino, have very different personalities. The elevators in the residential section are extremely easy to find and large enough to accommodate a wheelchair/scooter plus family members. The rooms, which I have visited but not stayed in, are capacious and well-suited to traveling with mobility equipment. The Guggenheims, which I discuss generally in another entry, have excellent access. Timed reservations to the exhibits ensure that the wheeled patron is not stuck behind a gaggle of standing people. The casino is more of a challenge. Elevators in this section are few and far between, forcing one's companions on foot to slog long distances, and the Grand Canal shops are true-to-life in that it is impossible to wheel in a straight line; a bench, person, curve in the path, or little statue is bound to pop up every few feet. Additionally, the railing to the canal itself, where gondoliers are singing to floating tourists, is just about at head-height for the seated tourist. I am not at all claustrophobic but I noticed that the combined noise, obstructions, and visual cut-off made me tired very quickly and we left after about ten minutes--no shopping done there, the Venetian's loss. Sincerely, if your desire to is to shop Burberry and Mikimoto at the Venetian on wheels, do yourself a favor and book your room there so you have someplace close to decompress afterwards. (That, or stay at Ceasar's and shop the Forum which I find a lot less tiring, believe it or not.)
So, keep some Chex Mix or a candy bar in your bag and a screw-top bottle of your favorite drink in your basket, remember to ALWAYS bring a sweater, attach your sense of humor firmly to your chin, and hit Vegas on wheels. A few barriers aside, I had a lot of fun without being a burden on my non-wheeled family members.