This article explores the lived experiences of men with mild intellectual disabilities who have deliberately set a fire and are detained in a secure hospital. Semi-structured interviews were used to explore the subjective experiential claims of seven male firesetters with mild intellectual disabilities residing in a forensic intellectual disability hospital. Interpretative Phenomenological Analysis was used to interpret participants’ meaning making of their firesetting. Five super-ordinate themes emerged from the analysis: (a) “the importance of the first fire,” (b) “firesetting to escape distress,” (c) “firesetting to enable positive emotional experiences,” (d) “firesetting to communicate with services,” and (e) “Fire Setters Treatment Programme.” The analysis provides an understanding of why some firesetting behaviours emerge and highlights factors that contribute to the maintenance and desistence of repeat firesetting acts. The findings are considered in relation to evolving risk assessment measures and risk reduction strategies for facilitating rehabilitation into community settings.