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Background Increased post-void residual urine volume (PVR) is often seen in geriatric populations. People with intellectual disabilities (ID) have risk factors in common with these populations. Aims To investigate in adults with ID: • Feasibility of portable ultrasound bladder scanning; • Prevalence of PVR; and • Relations with proposed risk factors for PVR. Methods In a cross-sectional design, PVR was measured using ultrasound scanning in 346 adults with moderate to severe ID aged 18–82 years. Relationship between increased PVR and the following risk factors was assessed: age, level of ID, gender, ambulancy, medication, chronic illnesses, incontinence and profound multiple disabilities (PMD). Acceptation of scanning and manageability were noted. Results Feasibility: All participants were cooperatively undergoing the ultrasound scan and all outcomes were sufficiently interpretable. Prevalence: PVR ≥ 150 mL was newly identified in 30/346 persons (8.7%, 95% confidence interval 5.92–12.14). Associations: Higher age (P = 0.001), laxative use (P = 0.001), chronic illnesses other than epilepsy (P = 0.005), profound ID (P = 0.008), incontinence (P = 0.048) and immobility (P = 0.005) are determinants that were associated with urinary retention. Conclusions The bladder ultrasound scan is a feasible method to identify increased PVR in adults with more severe levels of ID. The prevalence of PVR in adults is similar to prevalences found in the geriatric general population.