Background: Adolescents with intellectual disability in residential child care are a highly vulnerable population. The main goal of this study is to explore the characteristics of young people with intellectual disability in therapeutic residential care (TRC) in Spain and to identify the key variables associated with their referral to these services. Method: The total sample consisted of 473 young people in residential child care in Spain (63.8% boys), aged between 12 and 17 years (M = 15.32), divided into three different groups for comparison. An "ad hoc questionnaire" and the "Youth Self-Report" were used to collect information. Results: Participants with intellectual disability in TRC presented a higher frequency of externalising problems and risk behaviours than adolescents with disability in general residential programmes. However, it was lower than that of their peers without disability in TRC. Conclusions: Needs of adolescents with intellectual disability should be assessed before a referral to these facilities, in order to adapt the interventions provided.