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This article sets out to explore three differing approaches from three agencies to supporting and treating people with a learning/intellectual disability who have sexually offended. The three agencies are: Waymarks in the United Kingdom, York Central Hospital Behaviour Management Services and Vita Community Living Services both in Ontario, Canada. Each agency provides services to a similar population of offenders with disabilities. Though each client engaged in vastly different behaviour, all clients have been identified as having sex offending history and as having a high likelihood of offending again in the future. As the organisations evolved, differing approaches to the provision of service developed. For the three agencies, it can be argued that there was a very limited range of theoretical models available when each organisation developed. Consequently each agency developed their service according to the needs and ‘best fit’ of the people they were supporting with the available resources at that time. This meant that services developed as a direct response to the need and were designed to best fit the need with the resources to hand at the time. As a result, three different models of service arose, all of which have had real success with meeting the needs of people with learning/intellectual disabilities who have sexually offended, while providing support and treatment in differing ways. This article will examine some of those differences.