Violent behaviour displayed by individuals with intellectual disability (ID) is one of the biggest challenges to services. It can cause serious consequences to the health and well-being of the individual and those involved in their care, including exclusion from services or social groups. There is a greater risk of violence in the ID population and aetiological causes include biological and psychosocial factors and developmental disorders such as ASD and ADHD. Key management strategies involve a review of these factors, robust risk assessments and collaborative working utilising a multidisciplinary approach. Psychological and behavioural support interventions offered should be person-centred and tailored according to their needs. The goal is to assess and modify psychological, environmental or social factors and improve challenging behaviour. Pharmacological treatment can be helpful where underlying physical or mental health illnesses contribute to aggression. In those without obvious causes of violent behaviour, psychotropic medication can be also used to attenuate risks; however, current evidence base is limited and medication options should be considered on a case-by-case basis.