Unintentional injury is one of the leading causes for mortality in childhood. Choking or the interruption of respiration by internal obstruction of the airway, usually by food or small toys, is such a case. The present study was conducted to examine choking-related deaths from 1991-2005 among children with intellectual disability younger than 18 years of age living in residential care centers in Israel. The data for this study were obtained from the Office of the Medical Director (OMD), Division for Mental Retardation (DMR), Ministry of Social Affairs and Social Services. Every case of death in residential centers is reported to the OMD, who since 1991 has registered place of residence, date of birth, age at death, gender, ethnic background, level of ID, cause of death, autopsy and review committee, if established in a data register. The data concerned with food choking were extracted from the mortality register for the period 1991-2004. Over the study period (15 years) 1,107 cases of death were reported, with 5 (0.245%) caused by food choking in children. The average rate was 8.98 per 100,000 study population for food choking in children. The solution is prevention. In recent years, the OMD together with other professionals have produced educational material and seminars on feeding and preventive measures. Not every case can be prevented, but it is important to identify risk factors, to educate the care givers and professionals, and to ensure that food products that are common choking hazards are kept away from children, who are at risk.