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Accretion of plasma onto black holes power some of the most powerfulsystems in the cosmos. Supermassive black holes at the centers ofgalaxies represent the high-mass limit of these objects and so accountfor the most luminous accretors. As a result, their influence spansvast spatial and temporal scales of cosmic phenomena: intraclusterheating, intergalactic media, galactic feedback and star formation,kiloparsec-scale jets/outflows, variability over time scales of minutesto centuries, and luminous multi-wavelength electromagnetic emissionextending all the way down to its event horizon. Their intrigue isheightened by the fact that they lie at the intersection of variousphysical laws---e.g., general relativistic gravity,magnetohydrodynamics, radiation, high-energy particle physics,thermodynamics, and photo-ionization---which all must be reconciled toarrive at a fundamental understanding and probe for new physics, liketests of general relativity. These physics ingredients must beincorporated into simulations performed somehow on dynamical scalesranging 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 enablingprogress to larger scales, more degrees of freedom, and even to binarysystems. Some of the topics we will survey include recent progress onsimulating the relationship between the disk-jet interaction, howtilted black holes behave, radiation-dominated flow, and how binaryAGN affect the standard picture of black hole accretion. Along theway, we will highlight how new technologies have enabled thesescientific rewards. Future directions and open questions will beprovided to inspire discussion and interaction during the session.