LAS VEGAS — Donald Trump told voters the Supreme Court is “what it’s all about” in this election as he and Hillary Clinton squared off for their final debate ahead of the election, vowing to appoint justices who would be conservative and would overturn the Roe v. Wade abortion decision.

“That will happen automatically,” Mr. Trump said at the top of the debate.

Mrs. Clinton countered that she wanted to see a Supreme Court that is representative of all Americans, and ticked off a list of rights she said the justices need to preserve, including abortion rights.

And she fired back against Mr. Trump’s accusation that she would eviscerate the Second Amendment, saying she wants to see what she called reasonable exceptions.

“Dozens of toddlers injure themselves, even kill people with guns,” she said.

Left off the stage Wednesday, as in the previous debates, were Libertarian Party nominee Gary Johnson and Green Party candidate Jill Stein, neither of whom has performed well enough in polls to be part of the debates based on the threshold set by the commission that runs the affairs.

The two previous presidential debates this year saw uneven performances by Mr. Trump, who appeared unprepared in the first exchange and who faced headwinds in the second debate after a 2005 videotape emerged of him bragging about making unwanted sexual advances on women.

The debates helped change the narrative of the election. Mr. Trump had momentum in September, and had closed the gap with Mrs. Clinton.

That’s all dissipated, and the latest Real Clear Politics average of all polls shows Mrs. Clinton with 45.3 percent support nationally, Mr. Trump with 39.1 percent, Mr. Johnson with 6.5 percent and Ms. Stein with 2.5 percent.

Democrats, increasingly confident of Mrs. Clinton’s victory, have begun to shift resources into congressional races down the ballot, hoping to deliver majorities in both the House and Senate to give Mrs. Clinton a chance to pursue her agenda without a Republican opposition able to block her.

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