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Peer interaction and relationships are considered key factors in the academic success of students with disabilities, and serve as measurements of inclusive practice, since children with disabilities who are accepted tend to have positive relationships and interactions. This study explored the peer relationship and interaction patterns between students with visual impairments and their sighted peers at Sirigu Senior High School in Ghana. A concurrent triangulation design was used. One hundred sighted students and two resource teachers were purposively sampled, and 20 students with visual impairments were sampled using a census technique. Interview data were coded and analyzed using the thematic approach, while the questionnaire data were analyzed using descriptive statistics. Results from the study showed that there were no positive peer relationships between students with visual impairments and their sighted peers. The students indicated that some sighted peers were unfriendly and discriminatory. The study revealed that there were very limited interactions between the sighted and the visually impaired, and the visually impaired students expressed dissatisfaction with their participation in co-curricular activities. The study concludes that organizing more social activities would create a friendlier environment, and that the school could promote positive peer relationships and interactions through engaging students with disabilities in more co-curricular activities.