Literacy skills enhance opportunities for a meaningful life. Many adults with extensive support needs did not receive effective literacy instruction in school, which limits their future opportunities. We reviewed 17 research studies examining literacy interventions for these adults. We were interested in (a) who were the participants, (b) the types of literacy targets represented, (c) the types of interventions utilized, and (d) the outcomes of these interventions. Findings documented that adults with extensive support needs can and do acquire literacy skills across the lifespan. Although there is a promising trend to teach for meaning using a multi-component approach, few studies examined transfer of learning beyond the intervention setting. We discuss the implications of findings for future research and for practice.