This study investigated the effectiveness of a multicomponent reading intervention implemented with middle school students with severe reading difficulties, all of whom had received remedial and/or special education for several years with minimal response to intervention. Participants were 38 students in grades 6-8 who had severe deficits in word reading, reading fluency, and reading comprehension. Most were Spanish-speaking English language learners (ELLs) with identified disabilities. Nearly all demonstrated severely limited oral vocabularies in English and, for ELLs, in both English and Spanish. Students were randomly assigned to receive the research intervention (n = 20) or typical instruction provided in their school's remedial reading or special education classes (n = 18). Students in the treatment group received daily explicit and systematic small-group intervention for 40 minutes over 13 weeks, consisting of a modified version of a phonics-based remedial program augmented with English as a Second Language practices and instruction in vocabulary, fluency, and comprehension strategies. Results indicated that treatment students did not demonstrate significantly higher outcomes in word recognition, comprehension, or fluency than students who received the school's typical instruction and that neither group demonstrated significant growth over the course of the study. Significant correlations were found between scores on teachers' ratings of students' social skills and problem behaviors and posttest decoding and spelling scores, and between English oral vocabulary scores and scores in word identification and comprehension. The researchers hypothesize that middle school students with the most severe reading difficulties, particularly those who are ELLs and those with limited oral vocabularies, may require intervention of considerably greater intensity than that provided in this study. Further research directly addressing features of effective remediation for these students is needed.