Multiple-choice testing is considered one of the most effective and enduring forms of educational assessment that remains in practice today. This study presents a comprehensive review of the literature on multiple-choice testing in education focused, specifically, on the development, analysis, and use of the incorrect options, which are also called the distractors. Despite a vast body of literature on multiple-choice testing, the task of creating distractors has received much less attention. In this study, we provide an overview of what is known about developing distractors for multiple-choice items and evaluating their quality. Next, we synthesize the existing guidelines on how to use distractors and summarize earlier research on the optimal number of distractors and the optimal ordering of distractors. Finally, we use this comprehensive review to provide the most up-to-date recommendations regarding distractor development, analysis, and use, and in the process, we highlight important areas where further research is needed.