Adolescent girls with intellectual disabilities have limited access to sexual and reproductive health (SRH) information. Those who have reached puberty and begun menstruating face even greater challenges due to their high level of dependence on parents or caregivers. To date, most services have primarily focused on protective interventions, with insufficient emphasis on preventive and promotive measures. As a result, there is a growing call to shift the focus toward health promotion and prevention. However, a clear and comprehensive framework for implementing such efforts is still lacking. This study aimed to develop a promotion and prevention model to improve the SRH of adolescent girls with intellectual disabilities. This study employed the Delphi method, involving ten experts from diverse disciplinary backgrounds and professional experiences. Consensus on each item in every round was determined using the mean and standard deviation (SD), while Kendall’s W coefficient was applied to assess the degree of agreement among the experts across rounds. The Delphi method was conducted in three rounds. The final model comprises eight key aspects: public policy, supportive environment, community participation, individual skills, involvement of parents and families, services focusing on promotive and preventive efforts, cooperation and coordination, and monitoring and evaluation. The degree of agreement among the experts, as measured by Kendall’s W coefficient, reached 0.644 in the second round and 0.693 in the third round, indicating a good level of consensus. The ideal model for promotion and prevention to improve the SRH behaviors of adolescent girls with intellectual disabilities must be holistic, encompassing all supporting components. This model provides a valuable framework for policymakers and relevant institutions to design inclusive programs and policies aimed at enhancing SRH behaviors within this population. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.