Accommodations signify any change in the way a child is taught or tested without changing the construct he/she is required to demonstrate. Setting accommodations are changes in the conditions of the examination setting, such as special lighting, adaptive furniture, or changes in the location itself, accomplished by moving the student(s) to a separate room or organizing them in to smaller groups. However, one of the challenges confounding educators today is how to determine accommodations that will appropriately help candidates with disabilities, including those with visual impairment, to adequately demonstrate their knowledge and skills in a testing arena in parity with their sighted peers (Shriner & Destefano, 2003). This difficulty is compounded by the fact that an accommodation that helps one candidate may not work in the same way for another, thereby necessitating that accommodations be selected and administered on individualized basis. The Cameroon GCE Board started administering examinations to candidates with visual impairment in 2005, but understanding that candidates with visual impairment come to the testing environment with a broad range of strengths and weaknesses, it was necessary to get their perceptions on the setting accommodation currently in use at the Cameroon GCE Board in order to ascertain that the accommodation is meeting their needs. Vygotsky?s socio-cultural theory provided the theoretical perspective of this study. This qualitative study adopted the case study design for the inquiry. 12 candidates with visual impairment constituted the sample. Findings showed that candidates with visual impairment write the GCE in a separate room which was perceived by some of them as discriminatory, the Centre environments were not disability friendly, chairs and tables were not suitable for the use of the slate and stylus, while invigilators in some cases were noisy. Based on these findings, the study recommended that the GCE Board should ensure uniformity in the provision of the setting accommodation across Centres by setting accessibility stands and implement the setting accommodation after individual candidate evaluations.