Background: Feeding and swallowing disorders (FSD)-dysphagia are common in adults with intellectual disabilities and frequently overseen by caregivers. Aim: To determine the clinical factors that are relevant in daily practise associated with FSD in adults with intellectual disabilities. Method: Cross-sectional data were collected from medical files. In addition, a digital questionnaire was sent to the primary caregiver. Logistic regression analysis was performed on beforehand determined and associated clinical variables. Results: In total, 106 participants (age 19 to 89) were included, and 54% of these participants were classified as having FSD. Variables positively associated with FSD were increasing mealtime support needs (p = 0.000), coughing (p = 0.004), cramming food (p = 0.027) and having severe-profound intellectual disability (p = 0.001). The use of antipsychotic medication was negatively associated with FSD (p = 0.024). Conclusion: FSD is common in adults with intellectual disabilities and is associated with mealtime support needs, coughing, cramming food, the severity of intellectual disability, and the use of antipsychotic medication.