Radical acceleration is a successful, yet rarely utilized educational practice that assists educators in meeting the cognitive and affective needs of highly gifted students. Individual case studies and cohort studies of students who have radically accelerated are reviewed regarding combinations of procedures that result in successful acceleration, variables that appear to predict success and cognitive and affective outcomes. While research supports the use of radical acceleration for the positive cognitive and affective gains that result for highly gifted students, some concerns about the process have been identified. An outline is presented of procedures that have been shown to lessen the likelihood of unfavorable outcomes. These procedures include counseling support, study skills programs, and opportunities to foster social interaction with other students. The literature concerning radical acceleration strongly supports the wider adoption of this most successful intervention.