Both Intellectual Disability (ID) and Borderline Personality Disorder (BPD) can be associated with behavioral dysregulation including self-harm, impulsivity, and intense anger. When these two entities overlap, clinicians are faced with limited guidance. The American Psychiatric Association has guidelines for the diagnosis and treatment of Borderline Personality Disorder as well as the diagnosis of Intellectual Disability. The NADD press has published an adaptation of these diagnostic criteria for Borderline Personality Disorder as they apply to those with ID, but there are not yet any guidelines for treatment in co-occurrence of these disorders. This paper will review the literature on the co-occurrence disorders and propose treatment recommendations following the existing literature and in adapting current treatment strategies for people with ID.