Promoting access to the general curriculum for students with disabilities has emerged as a central theme of recent legislative and policy initiatives. Ensuring that students with severe disabilities benefit fully from the myriad learning and social opportunities available through the general curriculum remains an important challenge, particularly at the secondary level. We discuss peer support interventions, a form of peer-mediated intervention, as an effective approach for engaging youth with severe disabilities more meaningfully in the general curriculum, as well as promoting academic success for classmates serving as peer supports. We describe the core elements of these interventions, review research pertaining to the academic and social benefits available to participating students, and discuss factors that may account for the effectiveness and social acceptability of this intervention approach.