BACKGROUND: Despite the transformation initiatives, the inclusion of people with disabilities in sports remains a challenge. Athletes with disabilities (AWDs) in low- and medium-socioeconomic countries are still being left behind, including in South Africa. They are facing various challenges. OBJECTIVES: This study aimed to explore barriers and facilitators to sports participation and the needs of AWDs. METHOD: This was a qualitative study design based on semi-structured interviews. Interviews were conducted with South African Paralympians. Permission was obtained from a physical disability association. Ethical clearance was issued by the University of the Witwatersrand Human Research Ethics Committee. An interview schedule with predetermined questions was used to guide the interviews. Interviews were held face-to-face or online from 20 min to 30 min per interview. All participants gave consent. The data were transcribed verbatim and analysed in themes deductively. RESULTS: A total of 23 athletes participated, 12 of which were females and 11 were males. Participants were mostly Africans ( CONCLUSION: Results showed a need to scale up disability inclusion, especially regarding the rendering of healthcare services and making resources available. CONTRIBUTION: This article provides knowledge that may be useful as a baseline for developing a suitable intervention for AWDs.