The aim of this study was to describe the health status profile and identify the healthcare needs of adults with intellectual disability (ID) residing in 18 of Hong Kong's residential care facilities. The author employed a cross-sectional study using a structured questionnaire survey to collect data on 811 persons with ID (432 males, 53.3%, and 379 females, 46.7%) with an average age of 44. Of the residents, 107 (13.2%) had Down syndrome, 275 (34%) had epilepsy, and 134 (16.6%) had cerebral palsy. Some 25.4% were underweight and 27.3% were overweight. They had the same illnesses as the general population, but the relative frequencies were different. In terms of prevalence, the top five chronic conditions were epilepsy, hypertension, diabetes mellitus, cataract, and gout (compared to Hong Kong's general population, where the top five conditions were hypertension, diabetes mellitus, cataract, heart disease, and respiratory disease). Compared to the general population, the prevalence of epilepsy, dementia, and gout among the adults was higher and there was an earlier onset of dementia. Also noted was an increasing rate of common chronic diseases in the age group 40+. Adults with Down syndrome showed higher prevalence of cataract, gout, heart disease, thyroid disease, hemorrhoids, dementia, hypercholesterolemia, psoriasis, varicose veins, fatty liver, cirrhosis, sleep apnea, as well as prostatic hypertrophy. The author concludes that there is lack of information about healthcare service for people with ID in Hong Kong, and that the study findings should have implications for policy development in the area of healthcare services for people with ID.