Background: The role of shame in the development and maintenance of psychological distress in adults with mild-to-moderate intellectual disabilities has been relatively under-researched. This study provides a review of diverse current research that has implicitly or explicitly investigated shame processes in this population in some form. Methods: A narrative review of the literature was undertaken. An electronic search of four databases identified 17 studies that met the eligibility criteria. Results: Findings indicate that individuals with mild-to-moderate intellectual disabilities may experience difficulties with both external and internal shame, which appear to be related to increased psychological distress. Experiences of being shamed may significantly negatively impact on self-to-self and other self-relating, processes of social comparison, subsequent self-worth and emotional well-being. Conclusion: Shame may be a contributory factor in the development and maintenance of psychological distress and subsequent mental health issues in some adults with mild-to-moderate intellectual disabilities.