Background: Inconsistencies are found regarding the relationship between academic achievement and visual-motor integration (VMI), gender and socio-economic status (SES). Aim: The study examined the associations between academic achievement in different compulsory learning areas and VMI skills, and what role gender and SES play. Setting: A total of 863 participants (n = 538, low SES group; n = 325, high SES group) from 20 schools in four school districts in the North West province of South Africa were randomly selected to participate. Methods: The Beery Visual-Motor Integration Test, 4th edition (VMI-4) was used to evaluate the VMI, visual perception and motor coordination skills; and the June mid-year school assessment (JMSA) and the Annual National Assessment (ANA) marks were used to examine their academic achievements. Spearman rank-order correlations and stepwise regression analyses were used to, examine significant associations and unique contributors, respectively. Results: Small-to-moderate significant correlations were found between all the learning areas assessed during the JMSA and the ANA examinations and the VMI-4. The strongest correlations occurred between visual perception and most of the learning areas. Socio-economic status had the greatest predictive association with most of the academic learning areas. The largest contributions ([greater than or equal to] 10% moderate, [greater than or equal to] 25% great) of SES were found during the JMSA in English, life orientation, mathematics, natural science, social sciences and in the grade point averages. During the ANA, SES had the highest predictive contribution to English and mathematics. Conclusion: The overall academic achievement of learners could be negatively affected by their SES and visual perception skills, that suggest timeously prevention strategies to counter these effects.