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People with disabilities continue to experience significant challenges in accessing sexual and reproductive health (SRH) services, despite global declarations that guarantee their universal right to the same quality and standard of care without discrimination. However, there is a dearth of research in our region on this issue. This study aims to understand the family planning practices and needs of people living with disabilities in Gusau, Zamfara State, Northwest Nigeria. This is a qualitative exploratory methods that gather data from people with disabilities about their experiences and use of family planning methods. The study included key informant interviews with 8 representatives (both male and female) and 8 focus group discussions (FGDs) among various categories of people with disabilities. The transcribed and translated findings from the interviews and FGDs were analyzed using descriptive thematic analysis. The respondents generally expressed a high level of awareness and utilization of family planning (FP) services, with many preferring modern methods due to their effectiveness and safety. Most married people with disabilities actively use family planning methods, while it is less common among unmarried individuals with disabilities. Women with disabilities frequently use contraceptive implants, injectables, and pills, whereas men often use withdrawal and condoms. Common reasons for using family planning include limiting family size, economic hardship, child spacing, and promoting the health of PWDs and children. Non-use is often due to disability-related reasons such as needing more children for assistance, lack of knowledge, fear of side effects, and misconceptions. Barriers included communication challenges, stigmatization, and lack of disability-friendly services. Respondents called for government intervention, including free services, interpreters, and better accessibility to encourage greater participation in FP programs. Persons with disability actively use family planning methods, with married persons utilizing them more frequently than unmarried individuals. Among married women, implants, injectables, and pills are the predominant methods, while men typically opt for withdrawal and condoms. A comprehensive approach to recognizing the diverse challenges faced by people with disabilities is necessary. Health workers should be trained in skills and ethics to meet their needs. Sexual and reproductive health (SRH) information must target people with disabilities and correct public misconceptions about disability and reproduction. Policies should improve SRH access for people with disabilities, including economic empowerment, free family planning services, enhanced communication, and making facilities disability-friendly.