 <p>Since OS X 10.10, <code>NSStatusItem</code> has <code>button</code> property, which is a regular <code>NSView</code>-based control that conforms to <code>NSAccessibility</code> protocol and which allows to change <code>accessibilityTitle</code> property directly.</p> <p>On earlier versions of OS X, you can implement a custom button that looks and behaves exactly like vanilla <code>NSStatusItem</code> and assign it to the item via <code>-[NSStatusItem setView:]</code> method, then use <code>-[NSView accessibilitySetOverrideValue:... forAttribute:NSAccessibilityTitleAttribute]</code> on your custom control to provide a voiceover title.</p>