Systemic therapy works not just with the individual but those around them in trying to address difficulties and find ways forward. This approach has received increasing attention in learning disability settings over recent years. To date little is known about the provision of systemic therapy in learning disability services in the UK. This article provides an overview of systemic therapy and reports findings from a UK wide survey of NHS learning disability services. A questionnaire was designed for the purposes of this study and distributed through a number of routes to attempt to reach all learning disability practitioners interested in systemic work. Two key recruitment routes were through electronic member lists of professional associations. Because of their data protection policies it was not possible to calculate response rates. In total 14 services took part, providing information regarding 55 clinicians who use this approach in learning disability services. A range of formats and therapeutic models under the umbrella of systemic therapy were in evidence. Training levels varied widely as did the use of technical resources. The findings are discussed and the need for more evaluation of systemic work in learning disability settings is emphasised.