The primary objective of this paper is to present recent advances in our understanding of epilepsy and to discuss the implications of these advances to optimise health and social care supports for people with epilepsy and intellectual disability (ID). The high prevalence and impact of epilepsy among people with ID has been well described. Similarly well described are the considerable barriers epilepsy imposes on people with ID experiencing a fulfilling, prolonged, and healthy life. Recent advances in our understanding of epilepsy may reduce these barriers, in particular approaches to reduce sudden unexpected death in epilepsy, to reduce epilepsy-related hospitalisation, and to improve the social experience of people with ID. We propose a number of draft actions in response to recent developments in each of these three areas.