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Accretion of plasma onto black holes power some of the most powerful systems in the cosmos. Supermassive black holes at the centers of galaxies represent the high-mass limit of these objects and so account for the most luminous accretors. As a result, their influence spans vast spatial and temporal scales of cosmic phenomena: intracluster heating, intergalactic media, galactic feedback and star formation, kiloparsec-scale jets/outflows, variability over time scales of minutes to centuries, and luminous multi-wavelength electromagnetic emission extending all the way down to its event horizon. Their intrigue is heightened by the fact that they lie at the intersection of various physical laws---e.g., general relativistic gravity, magnetohydrodynamics, radiation, high-energy particle physics, thermodynamics, and photo-ionization---which all must be reconciled to arrive at a fundamental understanding and probe for new physics, like tests of general relativity. These physics ingredients must be incorporated into simulations performed somehow on dynamical scales ranging from that of the event horizon to parsec-scales. Fortunately, new computational and theoretical techniques---such as GPU computing, radiation transport, and and novel gridding techniques---are enabling progress to larger scales, more degrees of freedom, and even to binary systems. Some of the topics we will survey include recent progress on simulating the relationship between the disk-jet interaction, how tilted black holes behave, radiation-dominated flow, and how binary AGN affect the standard picture of black hole accretion. Along the way, we will highlight how new technologies have enabled these scientific rewards. Future directions and open questions will be provided to inspire discussion and interaction during the session.