© 2015, Springer Science+Business Media New York (outside the USA). While studies report associations between perinatal outcomes and both autism spectrum disorder (ASD) and intellectual disability (ID), there has been little study of ASD with versus without co-occurring ID. We compared perinatal risk factors among 7547 children in the 2006–2010 Autism and Developmental Disability Monitoring Network classified as having ASD + ID, ASD only, and ID only. Children in all three groups had higher rates of preterm birth (PTB), low birth weight, small-for-gestational-age, and low Apgar score than expected based on the US birth cohort adjusted for key socio-demographic factors. Associations with most factors, especially PTB, were stronger for children with ID only than children with ASD + ID or ASD only. Associations were similar for children with ASD + ID and ASD only.