Despite progression in policy towards greater inclusion over the last four decades, teacher insecurities regarding a lack of expertise in special educational needs and disability (SEND) remain. This qualitative case study research investigated the influence of the inclusion of visually impaired pupils on teachers' conceptualisations of inclusion and SEND. Baseline and end-of-study surveys were undertaken with teachers (n = 13) and support staff (n = 8) who would be working with a visually impaired pupil for the first time. Classroom observations and end-of-study interviews were undertaken with teachers in Key Stage 2 (n = 2) and Key Stage 3 (n = 5). Addressing VI inclusion did not require significant acquisition of specialist knowledge but could be managed successfully through ongoing, small-scale changes. These changes were sufficient to trigger reflection on the choice of pedagogical approaches and challenge teachers' conceptions of inclusion through changed knowledge and understandings of how some children learn. Findings support the view that what constitutes special in addressing SEND is less a need for specific pedagogical strategies but rather teacher capacity for reflection and reappraisal such that they deepen their understanding of inclusive practice.