This chapter addresses mathematics education for people with multiple disabilities (MD), who face significant challenges due to a scarcity of scientific literature and validated teaching materials. Defined by the association of two or more primary disabilities, such as visual, intellectual, or physical impairments, MD requires pedagogical approaches that consider the multiplier effect of these conditions on development and social inclusion. Effective strategies for this population include the use of functional curricula focused on autonomy and the use of concrete materials, such as Tangrams and Geoboards, for teaching geometry and fractions. Research indicates that systematic instruction, the use of assistive technologies, and alternative communication systems, such as tactile symbols, are fundamental to promoting meaningful learning. The chapter also highlights the need for constant teacher mediation to describe scenarios and anticipate activities, respecting the response time and sensory specificities of each student. Although theoretical gaps exist, an ethical commitment to adapting resources and clear communication are essential pillars for overcoming educational barriers and guaranteeing the right to full participation of these individuals in society.