Background: The extent of participation of adults with visual and severe or profound intellectual disabilities (VSPID) is unclear. Aims: To explore participation of adults with VSPID and the association between occurrence and importance of aspects of participation. Methods: Individual support plans (ISPs) of 40 adults with VSPID were analyzed: selected text fragments were categorized according to 125 previously operationalized statements that had different levels of importance and were divided into seven participation clusters. Results: The ISPs contained 2791 text fragments that related to a statement. All clusters were covered: the clusters ‘Experience and discover’ (91.7%), ‘Involvement’ (90%), and ‘Social relations’ (87.5%) were well covered. ‘Inclusion’ (53.6%) and ‘Leisure and recreation’ (57.1%) were mentioned less often. Among the 36 high-importance statements, two related to ‘Inclusion’ ‘Involvement’ and ‘Social Relations’ each, three to ‘Communication and being understood’ and five to ‘Self-management and autonomy’ had at least 30 text fragments. Conclusions: The participation domains ‘Experience and discover’ ‘Involvement’ and ‘Social relations’ are well-documented, suggesting that adults with VSPID participate in those areas. However, domains such as ‘inclusion in society’ and ‘leisure in society’ were not documented. This overview of participation offers residential facilities the opportunity to determine in which areas participation can be improved.