Athletes with intellectual impairments are eligible to compete in three Summer Paralympic sports – table tennis, swimming and athletics. They are also able to compete in the Summer and Winter Special Olympics, which is a large organisation devoted to sports participation for individuals with intellectual impairments. While athletes with intellectual impairments may have more limited capacity to learn new skills and tactics, the evidence suggests their ability to respond to training programs is similar to able-bodied athletes. Educating athletes with intellectual impairments requires additional considerations by the practitioner and will likely need to involve the athlete's carer. This chapter covers physiological, clinical and practical nutrition strategies for working with athletes with an intellectual impairment.