Adults with intellectual and developmental disabilities (IDD) unquestionably have desires to engage in sexual and intimate relationships (Black & Kammes, 2019). However, with high rates of abuse and exploitation among people with IDD (Shapiro, 2018), it is important to evaluate their education regarding sexuality and romantic relationships. This study systematically reviewed 21 articles that reported outcomes of sexuality interventions for older adolescents and adults with intellectual disability. Studies were published between 1990 and 2019, were from 11 countries, and included 863 participants. Studies were divided into two categories: those that focused on abuse prevention and those focused on developing healthy intimate relationships. Trends over time indicated that more abuse prevention studies were conducted before 2010, and more relationship development studies were conducted after 2010. Different curricula and training protocol were used, but the topics and methods used to teach the content were generally similar. Different measures were used to assess impact, but primarily consisted of knowledge measures or behavioral observations. Participants in all studies improved their knowledge or behavior following the interventions. We suggest that sexuality intervention research and practice focus on replication and building knowledge of the most effective research-based practices for this population.