BACKGROUND: The health and life expectancy of Australians with Down syndrome has improved dramatically over recent decades, resulting in more people living into adulthood and accessing community and hospital based health and social services. OBJECTIVE: This article presents information and resources helpful to general practitioners providing healthcare to patients who have Down syndrome. Healthcare issues through the lifespan are explored, the importance of proactive management is emphasised and strategies are outlined. DISCUSSION: Australians with Down syndrome are an interesting and rewarding group of people with whom to work. They present us with particular challenges in the way we provide healthcare and, in doing so, offer us an opportunity to improve the way we work with other patients who have cognitive and communication difficulties; chronic, complex health and social needs; family or paid carers involved in health management and those who require health advocacy as a part of healthcare provision.