diff --git a/README.md b/README.md
index 2706582..59b16bd 100644
--- a/README.md
+++ b/README.md
@@ -117,6 +117,7 @@ The below props allow modification of the Android ActionSheet. They have no effe
 | textStyle        | TextStyle                         | No       |         |
 | titleTextStyle   | TextStyle                         | No       |         |
 | messageTextStyle | TextStyle                         | No       |         |
+| autoFocus        | boolean                           | No       |  false  |
 | showSeparators   | boolean                           | No       |  false  |
 | containerStyle   | ViewStyle                         | No       |         |
 | separatorStyle   | ViewStyle                         | No       |         |
@@ -138,6 +139,10 @@ Apply any text style props to the title if present.
 #### `messageTextStyle` (optional)
 Apply any text style props to the message if present.
 
+#### `autoFocus`: (optional)
+If true, will give the first option screen reader focus automatically when the action sheet becomes visible.
+On iOS, this is the default behavior of the native action sheet.
+
 #### `showSeparators`: (optional)
 Show separators between items. On iOS, separators always show so this prop has no effect.
 
diff --git a/src/ActionSheet/ActionGroup.tsx b/src/ActionSheet/ActionGroup.tsx
index 9cacae7..b5f6b4d 100644
--- a/src/ActionSheet/ActionGroup.tsx
+++ b/src/ActionSheet/ActionGroup.tsx
@@ -1,5 +1,15 @@
 import * as React from 'react';
-import { StyleSheet, Text, Image, View, ScrollView } from 'react-native';
+import {
+  StyleSheet,
+  Text,
+  Image,
+  View,
+  ScrollView,
+  findNodeHandle,
+  AccessibilityInfo,
+  Platform,
+  UIManager,
+} from 'react-native';
 import TouchableNativeFeedbackSafe from './TouchableNativeFeedbackSafe';
 import { ActionSheetOptions } from '../types';
 
@@ -14,6 +24,28 @@ const BLACK_54PC_TRANSPARENT = '#0000008a';
 const BLACK_87PC_TRANSPARENT = '#000000de';
 const DESTRUCTIVE_COLOR = '#d32f2f';
 
+/**
+ * Can be used as a React ref for a component to auto-focus for accessibility on render.
+ * @param ref The component to auto-focus
+ */
+const focusViewOnRender = (ref: React.Component | null) => {
+  if (ref) {
+    const reactTag = findNodeHandle(ref);
+    if (reactTag) {
+      if (Platform.OS === 'android') {
+        // @ts-ignore: sendAccessibilityEvent is missing from @types/react-native
+        UIManager.sendAccessibilityEvent(
+          reactTag,
+          // @ts-ignore: AccessibilityEventTypes is missing from @types/react-native
+          UIManager.AccessibilityEventTypes.typeViewFocused
+        );
+      } else {
+        AccessibilityInfo.setAccessibilityFocus(reactTag);
+      }
+    }
+  }
+};
+
 export default class ActionGroup extends React.Component<Props> {
   static defaultProps = {
     title: null,
@@ -80,6 +112,7 @@ export default class ActionGroup extends React.Component<Props> {
       length,
       textStyle,
       tintColor,
+      autoFocus,
       showSeparators,
     } = this.props;
     const optionViews: React.ReactNode[] = [];
@@ -97,11 +130,13 @@ export default class ActionGroup extends React.Component<Props> {
 
       optionViews.push(
         <TouchableNativeFeedbackSafe
+          ref={autoFocus && i === 0 ? focusViewOnRender : undefined}
           key={i}
           pressInDelay={0}
           background={nativeFeedbackBackground}
           onPress={() => onSelect(i)}
           style={styles.button}
+          accessibilityRole="button"
           accessibilityLabel={options[i]}>
           {this._renderIconElement(iconSource, color)}
           <Text style={[styles.text, textStyle, { color }]}>{options[i]}</Text>
diff --git a/src/ActionSheet/index.tsx b/src/ActionSheet/index.tsx
index 5c11393..9889a88 100644
--- a/src/ActionSheet/index.tsx
+++ b/src/ActionSheet/index.tsx
@@ -66,13 +66,19 @@ export default class ActionSheet extends React.Component<Props, State> {
         ]}
       />
     ) : null;
-    return (
+
+    // While the sheet is visible, hide the rest of the app's content from screen readers.
+    const appContent = (
       <View
-        pointerEvents={this.props.pointerEvents}
-        style={{
-          flex: 1,
-        }}>
+        style={styles.flexContainer}
+        importantForAccessibility={isVisible ? 'no-hide-descendants' : 'auto'}>
         {React.Children.only(this.props.children)}
+      </View>
+    );
+
+    return (
+      <View pointerEvents={this.props.pointerEvents} style={styles.flexContainer}>
+        {appContent}
         {isVisible && !useModal && (
           <React.Fragment>
             {overlay}
@@ -107,12 +113,13 @@ export default class ActionSheet extends React.Component<Props, State> {
       titleTextStyle,
       message,
       messageTextStyle,
+      autoFocus,
       showSeparators,
       containerStyle,
       separatorStyle,
     } = options;
     return (
-      <TouchableWithoutFeedback onPress={this._selectCancelButton}>
+      <TouchableWithoutFeedback importantForAccessibility="yes" onPress={this._selectCancelButton}>
         <Animated.View
           needsOffscreenAlphaCompositing={isAnimating}
           style={[
@@ -144,6 +151,7 @@ export default class ActionSheet extends React.Component<Props, State> {
               titleTextStyle={titleTextStyle}
               message={message || undefined}
               messageTextStyle={messageTextStyle}
+              autoFocus={autoFocus}
               showSeparators={showSeparators}
               containerStyle={containerStyle}
               separatorStyle={separatorStyle}
@@ -264,6 +272,9 @@ export default class ActionSheet extends React.Component<Props, State> {
 }
 
 const styles = StyleSheet.create({
+  flexContainer: {
+    flex: 1,
+  },
   overlay: {
     position: 'absolute',
     top: 0,
diff --git a/src/types.ts b/src/types.ts
index 35515a6..19e44a1 100644
--- a/src/types.ts
+++ b/src/types.ts
@@ -23,6 +23,7 @@ export interface ActionSheetOptions extends ActionSheetIOSOptions {
   textStyle?: TextStyle;
   titleTextStyle?: TextStyle;
   messageTextStyle?: TextStyle;
+  autoFocus?: boolean;
   showSeparators?: boolean;
   containerStyle?: ViewStyle;
   separatorStyle?: ViewStyle;