Purpose <p>Individuals with below-average intellectual functioning face significant limitations in adaptive skills essential for daily living. They also experience delays in motor development. This study aims to assess the effects of Perceptual Motor Exercises (PME) on motor performance, social adaptation, and social self-efficacy in female students with mild intellectual disabilities (ID) through a randomized clinical trial.</p> Methods <p>A randomized, single-blind clinical trial was conducted involving 26 female students with mild ID, selected through convenience sampling and divided into two groups: a control group and a PME group. All participants were assessed at baseline and after 8&#xa0;weeks for motor performance using the Test of Gross Motor Development (TGMD-3), social adaptation using the Adjustment Inventory by Sinha and Singh, and social self-efficacy using Wheeler and Weld’s Children’s Social Self-Efficacy for Peer Interaction Scale. Data were analyzed using ANCOVA.</p> Results <p>The ANCOVA test results showed a significant difference between the post-test scores of motor performance (F = 212.17, <i>p</i> &lt; 0.001, partial η² = 0.90), social adaptation (F = 190.32, <i>p</i> &lt; 0.001, partial η² = 0.89), and social self-efficacy (F = 62.38, <i>p</i> = 0.003, partial η² = 0.73) between the research groups. The PME group demonstrated significant improvements in motor performance, social adaptation, and social self-efficacy compared to the control group.</p> Conclusion <p>This clinical trial suggests that perceptual-motor exercises may positively influence motor performance, social adaptation, and social self-efficacy in female students with mild intellectual disabilities. By potentially enhancing motor and adaptive skills, PME could contribute to a more positive self-perception and support their participation in social contexts.</p> Trial registration <p>This clinical trial was registered with Iran’s Clinical Trial Registration Center (IRCT) [IRCT20190908044722N4] on 26 February 2024.</p>