In European countries, people with intellectual disability live in a range of social systems shaped by culture and attitudes. They have experienced many changes over the centuries, often with little control over their impacts. Culture impacts attitudes towards people with intellectual disability, affecting the quality of education and healthcare that they receive. Deinstitutionalisation across Europe has not been uniform and depends on political will and financial support. The European Union has implemented policies supported by funding to effect changes to more inclusive education and healthcare. Training of health and social care professionals in the needs of people with intellectual disability is essential to ensure that progress continues in enhancing the quality of people’s lives.