Being the second most populous country in the world and with rich cultural, linguistic, and ethnic diversity, the patterns of care and services vary a great deal across India. However, some common underlying themes are discernible. There have been major governmental initiatives that have relevance for prevention of intellectual disability such as improved prenatal and perinatal care, immunization, nutritional status of young children. An ambitious nation-wide program for early detection and intervention for developmental delays has been recently launched by central government. Innovative models of family oriented parent mediated home-based interventions have been developed. Some progressive legislations for individual and family empowerment have been enacted; however, much needs to be done in terms of implementation. Community based approaches such as community based rehabilitation is slowly and steadily emerging as an approach to cover large sections of population. Special education services have had a fairly long history and a remarkable growth. Inclusive education for children 6-14 years old has seen phenomenal growth, though there are many unresolved issues such as quality of education and human resources in mainstream settings. Services for adults with ID is far and few and needs greater attention. Large gaps continue to remain in health services such as medical / psychiatric evaluation and management. One encouraging trend has been organization of parents into parent associations.