The KineAssist is a robotic device for gait and balance training. A user-needs analysis led us to focus on increasing the level of challenge to a patient's ability to maintain balance during gait training, and also on maintaining direct involvement of a physical therapist (rather than attempting robotic replacement.) The KineAssist provides partial body weight support and postural torques on the torso; allows many axes of motion of the trunk as well as of the pelvis; leaves the patient's legs accessible to a physical therapist during walking; servo-follows a patient's walking motions overground in forward, rotation, and sidestepping directions; and catches a patient who begins to fall. Design and development of the KineAssist proceeded more rapidly in the context of a small company than would have been possible in most research contexts. A prototype KineAssist has been constructed, and has received FDA approval and IRB clearance for initial human studies. We describe the KineAssist's motivation, design, and use.