Background: Choking is a serious and under-recognised condition for adults with intellectual disability (ID), with health, psychological and potentially fatal consequences. This study aims to determine the prevalence and risk factors for choking in a population-based sample of older adults with ID. Method: 597 adults with ID (mean age: 60 years old; SD = 8) were selected as part of The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Information was collected on choking history, comorbidities, challenging behaviours and eating difficulties. Logistic regression was employed to determine risk factors for choking history. Results: 17.3% of participants reported choking history. Eating difficulties, cerebral palsy, visual impairment, being [greater than or equal to] 65 years old and antipsychotic use increased the odds of choking history. Conclusions: Choking is prevalent in our sample. Managing choking risk requires specific responsibilities from the multidisciplinary team. Risk assessment, training staff and caregivers should be implemented in usual care.