This needs-assessment study evaluated the physical activity levels, needs, preferences, and requirements for exercise among individuals with visual impairments, aiming to establish evidence for the codesign of a subsequent home-based exercise program. The questionnaire, comprising 35 questions, was developed by a research team of disability and adapted physical activity experts. It was implemented for the online survey, collecting data from 145 adults with severe low vision and blindness between January 15 and January 29, 2024. Descriptive statistical analysis and content analysis were employed. Seventy-five participants (62.5%) were classified as overweight or obese, and only 15 participants reported engaging in the recommended levels of physical activity. Regarding the requirements for future home-based exercise programs, seven themes were identified: accessibility, nonvisual learning support, safety management, personalization, motivation, education, and technology. The results emphasized the urgent need for adapted home-based exercise programs that align with individuals' specific health conditions and abilities.