Background: Sexual offending has been attributed to empathy deficits, implicating interventions targeting empathy as a potential mechanism for reducing sexually harmful behaviour. However, there is less known about how appropriate and effective interventions are for individuals with intellectual disabilities. This review aims to provide a comprehensive synthesis of research findings in this area. Method: Four databases were searched, yielding 13 studies meeting the inclusion criteria which were appraised using the CCAT. Results: CBT group treatments adapted from mainstream treatment programmes for people with intellectual disabilities were widely used, demonstrating improvements in empathy and reductions in sexually abusive behaviour overall. Conclusions: Studies are limited by sample sizes, lack of control groups and inconsistent definitions of intellectual disabilities and sexually abusive behaviour. Future research should include evaluation of models other than CBT, further assessment of empathy-specific interventions and understanding of the mechanism underpinning empathy change.