Background: In Canada, individuals with intellectual disabilities (ID) make up approximately 25% of the epilepsy population. Despite making up only a small portion, adult hospitalization data in Canada shows that individuals with ID are significantly more likely to be seen in the ED, be hospitalized, and to die as a result of epilepsy and epilepsy complications, than individuals with typical cognitive development. Data looking at ED visits in adolescents with epilepsy and varying cognitive abilities is extremely limited. Methods: To address this, a retrospective chart review of 122 adolescents (42 MID and 80 typical cognitive development) with epilepsy between the ages of 14 and 18 was done. Results: Results showed that adolescents with typical cognitive development had significantly more ED visits (p=.006), and seizure related ED visits (p= .008) than adolescents with MID. Despite the reasons for ED visits not significantly differing between the two groups, adolescents with MID had significantly longer ED visits (p=.023). Finally, when looking exclusively at the MID group, results showed that females were significantly more likely to be seen at the ED than males (p=.001). Conclusions: Results suggest that ED visit frequencies differ among adults and adolescents with ID, potentially suggesting the presence of unique protective factors for adolescents.