There is ongoing debate about the best model of service provision for people with an intellectual disability who present severe behavioural challenges. The present paper reviewed research which evaluated a range of UK service provision in terms of impact on challenging behaviour and other quality of life indices. A literature search was carried out for English language papers from 1990 to 2010 using a range of databases. Secondary searches were carried out from references of relevant papers. Very few evaluations were found. The available research indicates that, on the whole, specialist congregate services for individuals with challenging behaviour appear to use more restrictive approaches which have limited effect on reducing challenging behaviour. The evidence for peripatetic teams is somewhat unclear. The two studies reviewed showed positive outcomes, but both had limitations that made it difficult to generalize the results. A similar limitation was found with the sole evaluation of a community based service. It is unlikely that one model of service provision will meet the needs of all individuals, however, more robust evaluations are required of existing service models to allow commissioners, service users, their families and carers to make fully informed choices about effective services for those who challenge.