Objectives <p>Reproductive autonomy is a fundamental human right, yet it remains a complex issue for visually impaired women. Therefore, this study aims to explore reproductive autonomy and examine the factors associated with reproductive autonomy among visually impaired women.</p> Results <p>A cross-sectional study was carried out in Tamil Nadu, India, involving 333 visually impaired women aged 18–44 (36.09 ± 5.97) from two districts. The study used a Reproductive Autonomy Scale (RAS) to assess reproductive autonomy, which comprises decision-making, freedom from coercion, and communication domains. The respondents had mean scores of 2.13 for decision-making, 2.05 for coercion, 3.74 for communication. The study found no significant differences in age, education, occupation, house ownership, community, and religion. Significant differences were found in the number of children across all domains, and the total RAS scores indicated that women with two or more children had higher reproductive autonomy. In spouse’s disability, spouses with disabilities scored higher in decision-making domain compared to spouses without disabilities. The study concluded that the visually impaired women had a higher degree of reproductive autonomy. The results highlight that most women experience shared reproductive decision-making and supportive communication with their partners, with minimal instances of coercion.</p>