English-language learners (ELLs) with special needs consistently languish in the American school system. The No Child Left Behind Act (NCLB) included ELLs as a minority group and required to hold schools accountable for reducing the achievement gap between ELLs and their white peers, however the act did not provide a specific direction for educators on how to help these students in the school context. A conceptual review was conducted to compiles information on critical issues and challenges ELLs with special needs face as well as useful tips for assessment and instruction. Critical issues and challenges include assessment and identification, teacher preparation and professional development, and legal and policy issues. The useful tips discussed rely on the utilization of guidelines for assessment, Response to Intervention (RTI), and the support of all stakeholders.