Eighteen academic library users who are blind were interviewed about their experiences with academic libraries and the libraries’ websites using an open-ended questionnaire and recorded telephone interviews. The study approaches these topics from a user-centered perspective, with the idea that blind users themselves can provide particularly reliable insights into the issues and potential solutions that are most critical to them. Most participants used reference librarians’ assistance, and most had positive experiences. High-level screen reader users requested help with specific needs. A larger number of participants reported contacting a librarian because of feeling overwhelmed by the library website. In some cases, blind users and librarians worked verbally without the screen reader. Users were appreciative of librarians’ help but outcomes were not entirely positive. Other times, librarians worked with users to navigate with a screen reader, which sometimes led to greater independence. Some users expressed satisfaction with working with librarians verbally, particularly if websites did not seem screen reader user friendly, but many users preferred independence. Participants agreed it would be helpful if librarians knew how to use screen readers, or at least if librarians were familiar enough with screen readers to provide relevant verbal cues. Many users liked and used chat reference and many preferred Purdue Online Writing Lab (OWL) to learn citation style, though learning citation style was challenging. Questions such as reference librarians’ role when e-resources are not equally accessible deserve wider discussion in the library literature and in practice. Given the challenges described by the research participants and legal requirements for equally effective electronic and information technologies, libraries and librarians should approach reference services for blind users more proactively. Recommendations are provided.