According to the National Council of Teachers of Mathematics, geometry and spatial sense are fundamental components of mathematics learning. However, learning disabilities (LD) research has shown that many K–12 students encounter particular geometry difficulties (GD). This study examined the effect of an integrated object representation (IOR) accommodation on the test performance of students with GD compared to students without GD. Participants were 118 elementary students who took a researcher-developed geometry problem solving test under both a standard testing condition and an IOR accommodation condition. A total of 36 students who were classified with GD scored below 40% correct in the geometry problem solving test in the standard testing condition, and 82 students who were classified without GD scored equal to or above 40% correct in the same test and condition. All students were tested in both standard testing condition and IOR accommodation condition. The results from both ANOVA and regression discontinuity (RD) analyses suggested that students with GD benefited more than students without GD from the IOR accommodation. Implications of the study are discussed in terms of providing accommodations for students with mathematics learning difficulties and recommending RD design in LD research.