The purpose of this study was to explore the views of visually impaired youth about teacher-initiated activity modifications during integrated physical education. This experiential qualitative study included 18 visually impaired youth (ages 12–15 years; seven girls, 11 boys). Each participant completed two semi-structured interviews as data sources for this study. Four themes were constructed based on a reflexive thematic analysis of the interview data: (a) modifications interpreted as care; (b) “the angel and the devil”: modifications highlighting impairment; (c) the two-way street to modifications; and (d) modifications are Band-Aids over flawed activities and curriculum. These themes expand upon the current literature by describing how visually impaired youth understand their experiences with modifications in integrated physical education contexts. For many of the participants, activity modifications represented a tangible example of physical education teachers caring for them and caring about their needs. As such, some support for previously explicated benefits of modifications is provided. However, a number of concerns were also raised by our participants about modifications, such as modifications representing poorly conceptualized Band-Aids over poorly constructed activities, as well as modifications spotlighting differences and impairments. Finally, modifications that are promoted as simple and superficial ideas by the literature and executed by physical educators without communication with students appear to be unfavored by visually impaired students. This finding provides further support for the need to shift pedagogical strategies and teaching behaviors to become more flexible and student-centered.