Purpose -This article aims to describe the development of secure services for women with intellectual disability in the UK and to outline what is known about their mental health needs.Design/methodology/approach -The paper is a general review which is based on what is known historically about the subject, findings from the current literature and the author's own personal knowledge of these specialist services.Findings -Secure services for women with intellectual disability have developed out of mainstream forensic and learning disability services.Originality/value -Although there is a reasonable body of literature on offending in the intellectually disabled population as a whole, little of this is specific to women. Despite this, the evidence there is suggests that women continue to require secure services and that they have significant mental health needs.There are differences in the family and social context of women's and men's lives, the experience and impact of life events, the presentation and character of their mental ill-health and consequently their care and treatment needs. These differences must be understood by policy makers and those planning and delivering services (Department of Health (DH), 2002).