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Digital knitting machines provide a fast and efficient way to create garments, but commercial knitting tools are limited to predefined templates. While many knitting design tools help users create patterns from scratch, modifying existing patterns remains challenging. This paper introduces KnitA11y, a digital machine knitting pipeline that enables users to import hand-knitting patterns, add accessibility features, and fabricate them using machine knitting. We support modifications such as holes, pockets, and straps/handles, based on common accessible functional modifications identified in a survey of Ravelry.com. KnitA11y offers an interactive design interface that allows users to visualize patterns and customize the position and shape of modifications. We demonstrate KnitA11y’s capabilities through diverse examples, including a sensory-friendly scarf with a pocket, a hat with a hole for assistive devices, a sock with a pull handle, and a mitten with a pocket for heating pads to alleviate Raynaud’s symptoms.