Purpose -This is an invited short overview from a clinician working in a national secure inpatient setting which aims to focus on inpatient forensic services for adolescents with developmental disabilities.Design/methodology/approach -The paper gives a brief overview of the needs of this population and the requirements for inpatient assessment and treatment.Findings -This is a complex population who are referred relatively late to inpatient services, often after recurrent failings in residential services where mental disorders are commonly unrecognised. Comprehensive multidisciplinary assessment and treatment are required for this group.Originality/value -This paper will be useful to a range of professionals dealing with adolescents with developmental disabilities who are engaging in offending and other high risk behaviours.