<p>Pupils with visual impairments in Tanzania’s special primary schools often grapple with emotional challenges that are deepened by limited access to appropriate counselling services. While such support structures have been introduced in some schools, they largely fail to consider the unique needs of pupils with visual impairment. This qualitative study, drawing on interviews, observations, and document reviews, involved 12 pupils, 2 school heads, 4 teacher counsellors, and 4 teachers. Although counselling services exist on paper, in practice, they often fall short, excluding the very pupils who need them most. Thematic analysis indicated that, even with the establishment of counselling services in 2020, these resources are still mostly unattainable and inadequately executed for pupils with visual impairments. Teacher counsellors noted a deficiency in trained personnel for inclusive counselling, while many pupils conveyed feelings of emotional neglect. These emotional difficulties were frequently associated with stigma, violations of confidentiality, and unhelpful physical and social environments that obstructed their capacity to obtain effective counselling. To bridge this gap, policies must go beyond inclusion in name and commit to designing counselling that is accessible, empathetic, and attuned to the realities of visually impaired pupils. Until then, the support intended to heal risks becoming yet another barrier.</p>