Background: The present study investigated decision-making in patients with Prader-Willi syndrome (PWS) using the Soochow Gambling Task (SGT). The objective was to assess whether adults with PWS have impaired hot executive functions and whether the deficit is specific to PWS or linked to intellectual disabilities. Method: The SGT performance of 26 adults with PWS was compared to that of 26 healthy adults matched on chronological age, and to that of 26 adults with intellectual disabilities but without PWS, matched on intellectual quotient level and chronological age. Results: The PWS adults showed an absence of learning pattern over trials in the SGT, unlike the healthy individuals, and showed equivalent performances to adults with intellectual disabilities. Conclusions: The results suggest a deficit of hot executive functions in PWS, which is linked to intellectual disabilities and not specific to the syndrome.