Despite the fact that adults with both intellectual disabilities (ID) and psychiatric disorders are at increased risk for physical health problems, few studies have described their medical concerns specifically. This study reports on the rates of physical health issues and completion of recommended health screenings among 78 adult outpatients with ID in a specialized psychiatric service. We conducted a retrospective chart review of physical health information gathered by the psychiatric nurse using a standardized head-to-toe assessment tool and compared findings from nursing assessments to health information collected at intake based on patient and caregiver perspectives. Psychiatric outpatients with ID had at least one physical health issue and most had multiple concerns flagged through nursing assessments, the majority of which were not documented at intake. Our findings highlight the important role of the psychiatric nurse in management of patients with ID and indicate the need for more comprehensive health monitoring.