diff --git a/src/LayoutBuilder.js b/src/LayoutBuilder.js
index 183ac99cf..1264e0df8 100644
--- a/src/LayoutBuilder.js
+++ b/src/LayoutBuilder.js
@@ -1406,6 +1406,8 @@ class LayoutBuilder {
 				listContext: this._accessibilityListStack.length > 0 ? {
 					depth: this._accessibilityListStack.length,
 					itemIndex: this._accessibilityListStack[this._accessibilityListStack.length - 1].itemIndex,
+					listNode: this._accessibilityListStack[this._accessibilityListStack.length - 1].node,
+					parentItemIndices: this._accessibilityListStack.slice(0, -1).map(e => e.itemIndex),
 					isFirstInItem: isFirstLine && this._accessibilityListStack[this._accessibilityListStack.length - 1].isFirstNodeInItem,
 					isLastInItem: line.lastLineInParagraph && this._accessibilityListStack[this._accessibilityListStack.length - 1].isLastNodeInItem
 				} : null,
diff --git a/src/Renderer.js b/src/Renderer.js
index c8293505f..c51cf69a4 100644
--- a/src/Renderer.js
+++ b/src/Renderer.js
@@ -195,6 +195,9 @@ class Renderer {
 
 		// Accessibility: manage logical structure elements based on this line's context
 		if (tagger && line._accessibilityContext) {
+			if (line.inlines) {
+				tagger._currentLineText = line.inlines.map(i => i.text || '').join('');
+			}
 			_manageAccessibilityStructures(tagger, taggerState, line._accessibilityContext);
 		}
 
@@ -664,7 +667,7 @@ function _manageAccessibilityStructures(tagger, state, ctx) {
 	// ==================== LIST MANAGEMENT ====================
 
 	if (curLC && !prevLC) {
-		// Entering a list for the first time
+		// Entering a list for the first time (or re-entering after mid-page close)
 		tagger.beginList();
 		tagger.beginListItem();
 	} else if (curLC && prevLC) {
@@ -672,14 +675,40 @@ function _manageAccessibilityStructures(tagger, state, ctx) {
 			// Nested list starting
 			tagger.beginList();
 			tagger.beginListItem();
+		} else if (curLC.depth < prevLC.depth) {
+			// Returning from nested list(s) — close each inner list level explicitly.
+			// Without this, currentList stays as the innermost L element and new items
+			// get added to the wrong list in the structure tree.
+			for (let d = prevLC.depth; d > curLC.depth; d--) {
+				tagger.endList();
+			}
+			// prevLC.itemIndex is the inner list's counter and is not comparable to
+			// curLC.itemIndex. Use parentItemIndices to get the outer list's item index
+			// from when we were inside the nested list.
+			const prevOuterItemIndex = prevLC.parentItemIndices[curLC.depth - 1];
+			if (curLC.itemIndex !== prevOuterItemIndex) {
+				tagger.beginListItem();
+			}
+		} else if (curLC.listNode !== prevLC.listNode) {
+			// Same depth but a different list — close the previous list and start a new one.
+			// Without this, adjacent {ul:[...]} blocks at the same depth are silently merged
+			// into a single L element because !curLC && prevLC never fires between them.
+			tagger.endList();
+			tagger.beginList();
+			tagger.beginListItem();
 		} else if (curLC.itemIndex !== prevLC.itemIndex) {
-			// New item at same depth (previous item was closed by processLineEnd)
+			// Same list, same depth, new item (previous item was closed by processLineEnd)
 			tagger.beginListItem();
 		}
-		// depth decrease is handled by processLineEnd + the next beginList/beginListItem
+	} else if (!curLC && prevLC) {
+		// Left all list nesting mid-page — close remaining lists now rather than
+		// deferring to the next page-change _closeAllOpenStructures call.
+		// This prevents stale L/LI/LBody references from accumulating and being
+		// pushed onto the listStack when a subsequent list begins on the same page.
+		while (tagger.getListDepth() > 0) {
+			tagger.endList();
+		}
 	}
-	// Leaving a list (prevLC && !curLC) is handled by tagger._closeAllOpenStructures on page change
-	// and by finalise() at document end
 
 	state.prevListContext = curLC || null;
 
diff --git a/src/accessibilityTagger.js b/src/accessibilityTagger.js
index 48735652a..da7bb70bc 100644
--- a/src/accessibilityTagger.js
+++ b/src/accessibilityTagger.js
@@ -65,6 +65,9 @@ class AccessibilityTagger {
 
 		// Current figure
 		this._currentFigure = null;
+
+		// Set by the renderer before each _manageAccessibilityStructures call; used in warnings
+		this._currentLineText = '';
 	}
 
 	/**
@@ -532,30 +535,54 @@ class AccessibilityTagger {
 
 	/**
 	 * Get the current parent element for adding new child structures.
-	 * Priority order: cell > LBody > Sect
+	 * Priority order: cell > row (TOC) > LBody > BlockQuote > Sect > Document
+	 *
+	 * Skips and nulls any reference that was cascade-ended by PDFKit without
+	 * the tagger explicitly closing it, which would otherwise cause
+	 * "Cannot add child to already-ended structure element" errors.
 	 *
 	 * @returns {object|null} The current PDFKit struct element to use as parent
 	 */
 	_getCurrentParent() {
 		if (this.currentCell) {
-			return this.currentCell;
+			if (!this.currentCell._ended) { return this.currentCell; }
+			console.warn(`AccessibilityTagger: currentCell was cascade-ended unexpectedly (line text: "${this._currentLineText}")`);
+			this.currentCell = null;
 		}
 		// For TOC tables, content goes directly under TOCI (the row), not a cell
 		if (this.tableIsTOC && this.currentRow) {
-			return this.currentRow;
+			if (!this.currentRow._ended) { return this.currentRow; }
+			console.warn(`AccessibilityTagger: currentRow (TOC) was cascade-ended unexpectedly (line text: "${this._currentLineText}")`);
+			this.currentRow = null;
 		}
 		if (this.currentLBody) {
-			return this.currentLBody;
+			if (!this.currentLBody._ended) { return this.currentLBody; }
+			console.warn(`AccessibilityTagger: currentLBody was cascade-ended unexpectedly (line text: "${this._currentLineText}")`);
+			this.currentLBody = null;
 		}
 		if (this.currentBlockQuote) {
-			return this.currentBlockQuote;
+			if (!this.currentBlockQuote._ended) { return this.currentBlockQuote; }
+			console.warn(`AccessibilityTagger: currentBlockQuote was cascade-ended unexpectedly (line text: "${this._currentLineText}")`);
+			this.currentBlockQuote = null;
 		}
 		if (this.currentSect) {
-			return this.currentSect;
+			if (!this.currentSect._ended) { return this.currentSect; }
+			console.warn(`AccessibilityTagger: currentSect was cascade-ended unexpectedly (line text: "${this._currentLineText}")`);
+			this.currentSect = null;
 		}
 		return this.documentElement;
 	}
 
+	/**
+	 * Returns the current list nesting depth as the tagger sees it.
+	 * Used by the renderer to close the right number of list levels.
+	 *
+	 * @returns {number} The number of currently open list levels.
+	 */
+	getListDepth() {
+		return this.listStack.length + (this.currentList ? 1 : 0);
+	}
+
 	/**
 	 * Close all currently open structures (for page transitions etc.)
 	 */