There is now extensive evidence that exposure to environmental adversity pre-natally and across the life course can have a pervasive negative impact on health and well-being. It is also clear, however, that there exists marked variation in the resilience or vulnerability shown by individuals, families and communities when exposed to adversity. In this presentation I will summarise what we know about the association between intellectual disability and exposure to environmental adversity and draw out implications for research, policy and practice.