At least 60% of children with disabilities have multiple disabilities including visual impairments (VI). Because the visual system is neurologically based, any problems of the neurological system will also likely affect vision. The estimated number of students with VI and additional disabilities has increased significantly over the years. Since the mid-1980s, the prevalence of children with VI and additional disabilities has increased an estimated 50% to as high as 75% of the total number of children with VI. Today, teachers of students with VI face increasing challenges in working with students who are visually impaired and have additional disabilities including autism spectrum disorders (ASD). Although no direct relationship between VI and ASD is documented, a number of studies found a relatively high incidence of autistic-like behavior or autism in students with VI. Those students not only have problems associated with VI, but exhibit unique patterns of behaviors and learning difficulties typically seen in ASD such as prolonged echolalia, rocking, and hand flapping. A question is thus raised to parents and professionals working with them: Do those students have VI and ASD (VI & ASD) or are they visually impaired with autistic-like behaviors? When students have an intellectual disability in addition to VI, it further complicates the question because some of them exhibit similar problems. This article addresses these issues with the main focus on intervention for students who have VI & ASD. (Contains 1 figure and 1 table.)