This chapter aims to provide an understanding of intellectual disabilities, which are problems with general mental abilities. It describes the understanding of intellectual disabilities in African context and indigenous knowledge beliefs. The chapter describes the term intellectual disabilities where learners with intellectual disabilities typically begin walking and talking later than what is developmentally acceptable. It explains the African perspective that shifts paradigms of intellectual disability learners in school settings. There are common causes of intellectual disabilities such as genetic conditions, problems during pregnancy, problems during childbirth, and illness or injury. This chapter discusses symptoms of learners with disabilities that assist teachers to diagnose the type of intellectual disabilities, and different levels of support needed by the learner to succeed and function in daily life. The effect and strategies of managing and support learners with intellectual disabilities from rural and urban school settings were included in the content of the chapter.