The serum albumin level is a widely accepted indicator of nutritional status in healthy adults and elderly individuals. However, there are few data regarding the distribution and correlates of serum albumin levels in individuals with intellectual and/or motor disabilities. We conducted a cross-sectional study at a public facility for individuals with intellectual and/or motor disabilities in Ibaraki prefecture, Japan. Health check-up data obtained in 2001 from 477 individuals with intellectual disability (286 males, average age 40.6 (SD 12.3) years; 191 females, average age 45.1 (SD 11.6) years) were retrospectively reviewed. With the exception of men with cerebral palsy, the serum albumin level was nearly normally distributed. The mean was 44 (SD 3.6) g/l for males and 44 (SD 3.6) g/l for females with intellectual disability, 43 (SD 3.2) g/l in males and 44 (SD 2.6) g/l for females with cerebral palsy, 41 (SD 2.7) g/l for males and 42 (SD 3.7) g/l for females with Down's syndrome, and 42 (SD 4.5) g/l for males and 41 (SD 3.2) g/l for females with severe motor and intellectual disabilities. Only six of 474 individuals (1.3 %) had a serum albumin <or= 35 g/l. Low serum albumin was related to age, use of anticonvulsants and/or major tranquilisers, use of other medications, high C-reactive protein (CRP), high zinc sulfate turbidity test (ZTT), low serum Hb and low serum Fe among men; among women, high CRP and high ZTT were related to low serum albumin. The present study found an unexpectedly low incidence of low serum albumin among institutionalised individuals with intellectual and/or motor disabilities. Low serum albumin was associated with age, medications and inflammation in men, as well as inflammation in women.