South Asian languages and literature offer many terms for mental retardation (MR), intellectual disability or cognitive impairment, with a range of concepts and meanings through three millennia of history. Responses to mental retardation are illustrated by stories from religious, medical, legal and psychological literature, translated from Sanskrit, Pali, Persian, Bengali and Tamil. These responses concern life stages and events such as pregnancy, birth and infancy, development of speech, social behaviour and play, entry and progress in education, and problems arising in these stages. More documentation is available on rulers’ sons, whose impairment might affect succession to the throne and other issues of legal status. Geographical conditions such as iodine deficiency are also implicated in mental retardation. The cumulative evidence raises many questions about appropriate responses in the present, and how human beings attribute value to others, or generate failure and low self-worth by flawed constructions. The riches of South Asian cultural history, and unexpected gifts from people with mental retardation, play their part in illuminating these issues.