Background: This review describes procedures to reduce and eliminate physical restraint of people with intellectual disability. One approach is to assess antecedent conditions associated with restraint and change them so that they no longer produce restraint-provoking behaviour. A second approach is to decrease the duration of restraint by establishing a fixed-time release (FTR) criterion. Methods: Research supporting these approaches within community-based service settings are presented. Results: Physical restraint can be effectively reduced and eliminated using antecedent intervention procedures and FTR contingencies. Conclusions: Future research on physical restraint reduction and elimination should be conducted among people with intellectual disability. Intervention should include explicit therapeutic goals and methods that are acceptable to service providers. Outcome evaluation should focus on long-term follow-up over months and years. Finally, organizations serving people who have intellectual disability should approach physical restraint reduction and elimination by dedicating sufficient resources and adopting evidence-based practices.