Although positive peer relationships can facilitate the academic learning, skill development, and emotional well-being of students with complex communication challenges, few peer interactions are likely to take place in school settings apart from intentional intervention and support efforts. We conducted a systematic review to identify and examine intervention approaches aimed at improving peer interaction outcomes for school-aged children with complex communication challenges who regularly used or might benefit from augmentative and alternative communication (AAC). We categorized 31 studies based on their primary focus and the manner in which AAC was incorporated into the intervention package. Although the configurations of these intervention packages varied, most were found to be effective at increasing measures of peer interaction. We also identified several methodological features of this literature that would benefit from additional attention (e.g., participant descriptions, treatment fidelity, social validity).We offer recommendations to practitioners and researchers for impacting this dimension of students' lives. (Contains 2 tables.)