A number of studies have shown the importance of dermatoglyphics as markers of prenatal disturbance in developmental disorders of unknown origin. Genetic and non-genetic factors are involved in the aetiology of intellectual disability (ID), although the cause remains unknown in up to 50% of cases. The aim of the present study was to analyse dermatoglyphic traits and abnormal palmar flexion creases as markers of environmental prenatal stress in children with idiopathic ID (IID) using a case-control study design. Three dermatoglyphic variables, which have been reported as altered in other congenital disorders, were considered were studied in a sample of 62 children with IID (IQ < 70) and 75 healthy controls (IQ > 70): (1) fingerprint patterns; (2) total a-b ridge count (TABRC); and (3) abnormal palmar flexion creases (APFCs). More arches, the simplest fingerprint pattern, and more radial loops, an unusual pattern, were found in IID cases in comparison to controls (chi23 = 9.26; P = 0.02), with especially marked differences in boys (chi23 = 6.5; P = 0.0008). A significant increase of APFCs was also found in the affected children (chi24 = 28.52; P < 0.00; odds ration = 3.86, 95% confidence interval = 1.77-8.47). For TABRC, the differences between IID cases and controls failed to reach the conventional level of significance. These findings suggest that environmental factors acting early in development, or mechanisms involving an interaction of genotype and environment could be involved in the aetiology of some cases of ID.