Menstrual health and hygiene (MHH) is a critical aspect of adolescent girls' health and well-being, particularly in low-resource settings. This mixed-methods study explores the complexities of MHH among adolescent girls with disabilities in Ohaukwu Local Government Area of Ebonyi State, Nigeria. A survey design was employed to collect data from 200 adolescent girls with disabilities, and in-depth interviews were conducted to gain a deeper understanding of their experiences and perspectives. The results show that 60% of the respondents were between 13-15 years old, and 40% had physical disabilities. Only 50% of the respondents used sanitary pads during menstruation, while 35% used cloths. The thematic analysis revealed several themes, including stigma and shame, lack of access to MHH facilities, inadequate knowledge about menstruation, and coping mechanisms. The study's findings highlight the need for inclusive MHH programs that cater to the unique needs of adolescent girls with disabilities. Policymakers and healthcare providers should prioritize accessible facilities, tailored education, and awareness to promote menstrual health and well-being. The study's findings have implications for policy and practice, emphasizing the importance of addressing MHH challenges among adolescent girls with disabilities in low-resource settings.