Although the orthographic processing skill of recognizing and producing letters and letter patterns has been established as an important skill for developing spelling, a majority of the research focus has been on early orthographic intervention that did not progress beyond the unit of the letter. The purpose of this article is to provide a best evidence synthesis of current high-quality, peer-reviewed, experimental or control studies on spelling interventions with a focus on orthographic patterns (N = 5). This small synthesis revealed that spelling interventions with an orthographic pattern focus appear to contribute to the significant improvement of spelling skills in kindergarten through ninth-grade students with and at risk for reading disabilities. Several intervention approaches with varying methods to improve orthographic pattern knowledge were considered and were related to moderate to large effect sizes on standardized measures of spelling. Thus, the reviewed interventions appear to reflect educationally significant changes in orthographic pattern knowledge that transferred beyond that of taught spelling words.