The aim of this study was twofold: (1) to identify factors associated with a high level of accommodation needs in school activities among students with special educational needs (SEN) in regular upper secondary education; and (2) to investigate the extent to which schools have met students’perceived accommodation needs. Accommodation needs and their provision in school activ- ities were assessed with the School Setting Interview for 484 students with SEN. Students’mean age was 17.3 years and 50% did not have a diagnosis. A logistic regression analysis revealed that a high level of school absence, studying a vocational pro- gramme, and a neuropsychiatric disorder were associated with a high level of accommodation needs. In the majority of school activities, about 50% of students had not received any accommo- dation despite an experienced need for support. About 30% of students perceived a need for support even though they had been provided with accommodations, and around 25% stated they were satisfied with received accommodations. Regular upper secondary school students with SEN are insufficiently provided with accom- modations to satisfactorily participate in education. Specific stu- dent characteristics, e.g. high level of school absence, should receive special attention when investigating and accommodating students’needs for support in school activities.