For many years, the promotion of choice has been a core objective for virtually every service provider working to support people with learning disability. This is confirmed by the 2001 English White Paper Valuing People, A New Strategy for Learning Disability for the 21st Century, which describes choice as one of four key principles at the heart of the UK Government's proposals, and the 2000 review of learning disability services commissioned by the Scottish Executive, People Like Us, which places a similarly high priority on the creation of choice. The present paper gives an overview of our current understanding of the concept of choice. It concludes that our aspirations to promote choice for people with learning disability are undermined by conceptual confusion about the meaning of choice, inappropriate methods for helping people to make choices and an absence of applied research to guide practice in service settings. This review is designed to establish a conceptual framework for examining choice and empowerment for people with learning disability, and to describe the implications for future research and practice.