Objectives: Although it has been well documented that judo athletes from different competitive levels often exhibit inadequate hydration status, studies investigating the hydration habits of Paralympic judo athletes with visual impairment are scarce. Thus, this study examined urine-based hydration indicators and hydration-related behaviors of para judo athletes. Methods: Twelve judo athletes (6 women and 6 men) with visual impairment from the national Paralympic judo team voluntarily participated in the study. Athletes’ hydration status was assessed through urine specific gravity (USG), urine color (UC), and body weight (BW) changes over 24 hours, monitored at six time points. Additionally, athletes’ hydration knowledge, attitudes, and behaviors were evaluated using a hydration survey administered in an accessible format. Results: At rest, USG remained stable across measurement points (F3,33 = 1.11; p = 0.36), while urine color increased following both training sessions. The evening judo training session induced a significant increase in USG (p = 0.009), whereas morning training had no effect. Body weight decreased significantly after both training sessions (p < 0.001), but overall 24-hour body mass remained stable (p > 0.05). Athletes demonstrated high levels of hydration knowledge (68.5%) and attitudes (70.2%), but only moderate hydration behaviors (62.2%). No significant associations were observed between survey scores and urine-based hydration markers (p > 0.05). Conclusions: These findings indicate that Para judo athletes with visual impairment experience persistent challenges in maintaining day-to-day fluid balance despite adequate theoretical knowledge. Therefore, accessible, behavior-oriented hydration strategies and structured monitoring approaches should be developed for this underrepresented group, with active involvement of coaches and nutrition professionals.