The use of self-report to assess anxiety in adolescents with intellectual disability (ID) is notably underexplored. This study examined the impact of youth-level factors (i.e., age, verbal and cognitive ability, adaptive skills) on anxiety self-report completion and parent-youth agreement among 72 autistic adolescents with ID. We also examined if parent accommodation behaviors, such as reassurance or routine modification, served as predictors of parent-youth agreement of anxiety. Results showed that 83% of adolescents completed the self-report measure, with verbal, cognitive, and adaptive ability predicting completion. Parental accommodation predicted parent-youth agreement on physical anxiety symptoms, but not global anxiety symptoms. Youth-level factors did not significantly predict agreement. Results highlight the need for expanded assessment approaches for assessing anxiety in youth with ID.