We reviewed communication intervention studies involving people with Rett syndrome. Systematic searches of five electronic databases, selected journals, and reference lists identified nine studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participant characteristics, (b) target skills, (c) procedures, (d) main findings, and (e) certainty of evidence. Across the nine studies, intervention was provided to a total of 31 participants aged 2:7-17:0 (years:months). Communication modes included speech, gestures, communication boards, and computer-based systems. Targeted communication functions included imitative speech, requesting, naming/commenting, and various receptive language skills (e.g., respond to requests, answer questions, receptively identify symbols). Intervention approaches included early intensive behavioral intervention, systematic instruction, and music therapy. Positive outcomes were reported for 26 (84%) of the 31 participants. However, these outcomes must be interpreted with caution because the certainty of evidence was inconclusive for all but one of the studies. Due to the limited number of studies and their methodological limitations, the evidence base supporting current approaches to communication intervention for individuals with Rett syndrome remains inconclusive. (Contains 1 table.)