This systematic review article summarizes the effects of explicit text structure instruction on expository text comprehension for adolescents with learning disabilities or at risk for reading failure. A thorough literature search with four databases and backward citation search identified nine studies published in the past 22 years for inclusion in the review. The findings revealed medium to large effect sizes on expository reading comprehension outcome measures, providing moderately strong evidence in support of text structure intervention for adolescents with a diagnosis or risk of reading disabilities. Text structure instruction was more effective than standard instruction or business as usual conditions on students' comprehension of a variety of expository text types and content area texts. Directions for further research, limitations, and educational implications are discussed.