This study examines factors influencing the academic performance of visually impaired girls in mathematics education in Zambia. Despite national policies promoting inclusive education, significant achievement gaps persist for this group. A mixed-methods descriptive survey design was used, incorporating questionnaires, semi-structured interviews, and classroom observations with 60 learners, 15 teachers, and 5 administrators across 5 purposively selected secondary schools in Lusaka and Copperbelt Provinces. Findings reveal four interrelated factors: 1) Psychological barriers, including math anxiety and low academic self-efficacy; 2) School-based constraints, such as inadequate teacher training in adaptive pedagogy and shortages of Braille textbooks and tactile learning aids; 3) Socio-economic challenges, particularly household poverty limiting access to assistive devices; and 4) Cultural beliefs that devalue education for girls with disabilities. The study concludes that isolated interventions are insufficient. It recommends integrated strategies: mandatory in-service training on inclusive mathematics instruction, state-funded provision of assistive technologies, school-based psychosocial support programs, and community sensitization campaigns to address stigma. These measures are essential for achieving equity in STEM education.