Equations and inequality are among the basic concepts in the process of learning mathematical concepts and performing algebraic operations. Accessible practices based on the disabilities of students with visual impairments should be included in equation and inequality concept learning processes. To design these practices, this research aimed to examine the thinking of the students with visual impairment for equations and inequality. The participants of the research designed in the case study, as determined by criterion sampling method, were two students with visual impairment in the tenth grade. The data obtained through semi-structured interviews enriched with various tactile supportive training tools were analyzed using the content analysis method. Findings reveal that critical points in students’ thinking are concept definition, using symbols, writing equations and inequality expressions, performing operations, and selection of supportive training tools. The results indicate that the conceptual understanding of sub-concepts and symbols, as well as the use of discourses and symbolic language, are important for procedural understanding. The fact that the problem scenarios are based on the daily life experiences of the students with visual impairment and that they cover different contexts from the linear relationship is presented as a suggestion that is reflected in the students’ thinking.