Manipulatives are considered a common tool for mathematics teaching and learning, for both students with and without disabilities. Yet, a systematic review of the current state of research regarding manipulatives for students with disabilities did not exist prior to this article. This manuscript presents a systematic review of the literature regarding manipulatives for mathematics teaching and learning for students with disabilities. A total of 36 articles involving manipulatives and mathematics for students with disabilities were found: 7 that examined the impact of student learning with manipulatives and 29 that explored the impact of manipulatives use through the delivery of the concrete-representational-abstract (CRA) approach. This article presents the characteristics of the current state of research on manipulatives for students with disabilities as well as the implications of the research base for teachers and students.