Since the commencement of intellectual disability nurse training in 1959, both education and service provision philosophies have changed over time in Ireland. These changes have occurred in response to national and international reports and attitudes. Coinciding with the changes in education and philosophy have been the development and advancement of the intellectual disability nursing profession. Currently undergraduate intellectual disability nurse education is unique to Ireland and the United Kingdom and, similar to the developments across other disciplines of nursing, advance practice has become a focus of development. This article traces the development of intellectual disability clinical nurse specialists (CNSs) in Ireland and identifies possible challenges and implications for future practice.