This study investigated Chinese special education teachers’ perceptions and practices of individualizing instruction for students with intellectual and developmental disabilities (IDD). Semistructured interviews were conducted with 31 teachers who taught elementary Chinese language arts and math in six public special education schools for students with IDD in Shanghai. In addition, lesson plans written by 19 of the 31 teachers were collected. Thematic analysis revealed that teachers recognized the necessity of adapting instruction. However, practices and beliefs associated with one-size-fits-all approaches to teaching were prevalent. Although all teachers described making efforts to address individual differences, these efforts appeared to be inadequate. Teachers perceived fully addressing the needs of individual students as difficult and described challenges in four areas.