Approximately 1 in every 10 soon-to-be-released prisoners in Australia lives with an intellectual disability, yet remarkably little is known about their health and justice-related outcomes following their release from prison. This study aimed to understand the health and social needs during transition out of prison for people with intellectual disability across two Australian states: Queensland and Western Australia (WA). We interviewed 17 service providers to seek their perspectives about where gaps in the transition out of prison exist and which specific steps can be taken to address unmet need for ex-prisoners with intellectual disability. Our analysis of key themes identified inadequate life skills, identification of disability, system complexities and combative relationships as crucial gaps to providing comprehensive and effective support during the transition out of prison. Key facilitators to overcoming these gaps included timely planning of transition, continuity of care, relationships and trust, training of service providers and the National Disability Insurance Scheme (NDIS). This arena is complex. Our results indicate that there exist clear differences between policy, service delivery objectives and actual delivery of service to ex-prisoners with intellectual disability. Our findings suggest a clear mandate for modifications and adjustments to current support arrangements (or the creation of support where it is currently absent) and the need for systemic change to address ‘wicked problems’ that hinder the ability of ex-prisoners with intellectual disability to remain out of prison and healthy.