There has been relatively limited research on the mental health of people with a learning disability, in spite of the high prevalence of disorder in this population. Anxiety disorders are among the most common psychological difficulties, and comprise a considerable proportion of research effort in the general adult field. However there is a dearth of research involving people with a learning disability. Consequently models of anxiety are based on the general adult population and there has been little consideration of the way in which anxiety in people with a learning disability should be conceptualised. One reason for this, may be the difficulty in developing relevant assessment tools due to communication problems and lack of procedural standardisation in a relatively heterogeneous population. However the recent development of a DSM-IV based psychiatric interview represents substantial progress in this area. In this review the need for the development of self-report measures of anxiety is considered in some depth. Such measures are widely available in adult mental health and are useful for symptom screening, outcome measurement and as an aid to diagnosis. The development of a reliable and valid scale for use with people with a learning disability is long overdue.