Recent data suggest that a majority of secondary students read below the level considered proficient on state standardized tests of reading. Alternative high schools, in particular, serve a high proportion of struggling readers. This survey study investigated reading instruction provided to struggling readers in alternative schools in one state by determining: (a) the types of supplemental reading instruction provided, (b) the methods of referral, and (c) educator-perceived barriers to providing that instruction. Findings indicate that most alternative schools offer supplemental reading instruction and that standardized assessments are the primary method of referral. Lack of staff and instructional resources, poor student behavior and motivation, and insufficient time were all identified as barriers to providing instruction. Implications for research and practice are also identified.