This article reports a synthesis of intervention studies conducted between 1994 and 2004 with older students (Grades 6-12) with reading difficulties. Interventions addressing decoding, fluency, vocabulary, and comprehension were included if they measured the effects on reading comprehension. Twenty-nine studies were located and synthesized. Thirteen studies met criteria for a meta-analysis, yielding an effect size (ES) of 0.89 for the weighted average of the difference in comprehension outcomes between treatment and comparison students. Word-level interventions were associated with ES = 0.34 in comprehension outcomes between treatment and comparison students. Implications for comprehension instruction for older struggling readers are described.