Two studies aimed to investigate the reading comprehension abilities of 14 readers with Down syndrome aged 6 years 8 months to 13 years relative to those of typically developing children matched on word reading ability, and to investigate how these abilities were associated with reading accuracy, listening comprehension, phonological awareness and vocabulary knowledge. Study 1 confirmed significantly poorer passage-reading comprehension than the typically developing group. In an experimental task, readers with Down syndrome understood fewer written sentences than the typical group and, contrary to prediction, received no advantage from printed sentences compared to spoken sentences, despite the lower memory load. Reading comprehension was associated with listening comprehension, word reading and phonological awareness in DS. Vocabulary knowledge was also associated with reading comprehension, mediated by word reading and nonverbal cognitive abilities. Study 2 investigated the longitudinal relationships between reading and language measures in the readers with DS over around 22 months. Time 1 listening comprehension and phonological awareness predicted Time 2 reading comprehension but there was no evidence that reading or reading comprehension predicted Time 2 language scores or phonological awareness, and no evidence that readers had acquired greater depth of vocabulary.