Eating and drinking difficulties are highly prevalent in the intellectual disability population and include all aspects of the eating and drinking process. This can include stable positioning and pacing the meal all the way through to safe swallowing. Dysphagia is a subset of wider eating and drinking difficulties, often seen in the intellectual disability population. Dysphagia presents as a difficulty chewing and swallowing. It is often the underlying cause of malnutrition, dehydration, weight loss, choking, and aspiration pneumonia, with risks to mental health, social isolation, dignity, and enjoyment. A deterioration in eating and drinking skills is often a symptom of a broader physical and mental health diagnosis. People with eating and drinking difficulties can also experience a cyclical decline in health and an increased risk of malnutrition and dehydration. In addition to eating and drinking difficulties this chapter covers surgical intervention requiring insertion of a gastric tube, the impact of medication on feeding, and strategies to manage eating and drinking difficulties.