Purpose: To examine the speed profiles of elite wheelchair rugby (WCR) players during game-simulation training drills of differing player number and shot-clock regulations. A secondary aim was to determine whether the profiles were further influenced by player classification. Methods: Eight elite WCR players (low-point n = 3, high-point n = 5) were monitored using a radio-frequency-based indoor tracking system during training sessions over a 5-mo period. Speed profiles were collected for 3 modified game-simulation drills—3-versus-3 drills (n = 8 observations), 30-s shot clock (n = 24 observations), and 15-s shot clock (n = 16 observations)—and were compared with regular game-simulation drills (4 vs 4, 40-s shot clock; n = 16 observations). Measures included mean and peak speed; exercise-intensity ratios, defined as the ratio of time spent performing at high and low speeds; and the number of high-speed activities performed. Results: Compared with regular game-simulation drills, 3-versus-3 drills elicited a moderate increase in mean speed (6.3%; effect size [ES] = 0.7) and the number of high-speed activities performed (44.1%; ES = 1.1). Minimal changes in speed profiles were observed during the 30-s shot clock, although moderate to large increases in all measures were observed during the 15-s shot-clock drills. Classification-specific differences were further identified, with increased activity observed for high-point players during the 3-versus-3 drill and for low-point players during the 15-s shot clock. Conclusion: By reducing the number of players on court and the shot clock to 15 s, coaches can significantly increase elite WCR players’ speed profiles during game-simulation drills.