Effective vocational instruction is an essential aspect of preparing students with intellectual and developmental disabilities (IDD) for the world of work. We systematically reviewed research on instructional methods used to teach employment skills to secondary students with IDD. We identified 56 studies involving 766 participants with IDD. Four intervention approaches emphasized technology or some other instructional stimulus (i.e., self-management devices, video-based, audio-based, picture and tactile-based) and four focused on live instructors (i.e., direct instruction, augmentative and alternative communication, simulation, peer-delivered). Among the 21 instructional methods used within these approaches, performance feedback, device-assisted instruction, response prompting, and community-based instruction were the most common. We address the extent to which these intervention approaches were effective across students, instructional methods, settings, and outcomes, as well as offer recommendations for future research and practice.