Pragmatic language skills are often impacted in individuals with intellectual disability, a developmental condition defined by deficits in intellectual and adaptive skills. In this chapter, we review the literature on pragmatic language in three genetically-based causes of intellectual disability – Down syndrome, fragile X syndrome, and Williams syndrome. We focus on group-comparison studies of young verbal individuals and cover a range of critical pragmatic skills (e.g. speech acts, topic initiation and maintenance, management of communication breakdowns, and narrative). We draw special attention to matching strategies utilized in the design of these studies which have critical implications for interpreting existing literature and guiding future studies. We conclude with discussions of theoretical implications, research directions, and clinical applications based on our review.