Purpose: Living with a dual sensory loss (DSL), the impairment of both vision and hearing, has a significant impact on the daily life for many older adults, particularly limiting an individual’s ability to access information from their surroundings and to communicate effectively. Method: This study investigated the communication modes (n = 513; spoken, manual), communication systems use (n = 513; e.g., oral, signed, tactile), and communication participation (n = 302; participation in conversation, groups, social activities, loneliness) of adults aged 50 years and older who had been diagnosed with a DSL. Results: The majority of older adults with DSL used oral communication, with a small number using manual forms of communication, and few people using both oral and manual communication. Those who used oral communication tended to be older and had later onset of vision loss, hearing loss, and dual sensory loss. Severity of DSL and vision loss were not associated with communication participation. Severity of hearing loss was associated only with ability to participate in group conversations and withdrawal from conversation. Regardless of the communication mode used, older adults with DSL reported difficulties with communication participation, especially in terms of participating in group conversations, and reported frequently withdrawing from conversation, being alone when they would rather not be, and limited participation in social activities outside of the home. Conclusions: Communication participation is a frequent difficulty for older adults with DSL. Research is required to gain a richer understanding of the communication participation of older adults with DSL and how they and their communication partners can best be supported.