Researchers have consistently pointed to teacher deficit views, inequitable identification of policies and practices, and differential access to resources to explain the dearth of traditionally underserved learners in gifted programs across the nation. Culturally relevant leadership is one way to remedy this problem through systemic educational reform at the district and school levels. The purpose of this article is to provide a systematic review of the literature on leadership, systemic reform, and identification and services in gifted education for culturally, linguistically, and economically diverse (CLED) K-12 students in the United States. Drawing from this literature, we report what we know to date on systemic district reforms and their consideration of minoritized populations in gifted education through five themes: systemic bias; equity and excellence; deficit thinking; hiring practices, training, and professional development; and parent and community networks. We then reflect on the potential for equitable systemic reform efforts inclusive of CLED students.