Introduction: Solution-focused brief therapy (SFBT) has a growing evidence base and several authors have recognized the advantages of applying this approach with people with intellectual disabilities (ID). The purpose of this review is to summarize and critique the literature that has used solution-focused (SF) approaches in ID, and consider future directions. Methods: A literature review was carried out, identifying 12 studies; six with individuals, and six with staff and families. Results: There is preliminary evidence for the effectiveness of SFBT for individuals with mild ID and Solution-Focused Coaching or Consultation (SFC) for staff working with individuals with moderate and severe ID. However, the current evidence base consists primarily of case studies. Recommended adaptations include shortened scales and more concrete approaches to eliciting exception-seeking. Conclusions: Solution-focused techniques should be modified to accommodate the cognitive abilities of people with ID and carers should be involved in sessions where possible. There is a need for further controlled studies, with valid and reliable outcome measures, larger samples, and longitudinal data.