Understanding text can increase access to educational, vocational, and recreational activities for individuals with autism spectrum disorder (ASD); however, limited research has been conducted investigating instructional practices to remediate or compensate for these comprehension challenges. The current comprehensive literature review expanded previous reviews and evaluated research quality using Reichow (Evidence-based practices and treatments for children with autism, pp 25–39. doi:10.1007/978-1-4419-6975-0_2, 2011) criteria for identifying evidence-based practices. Three questions guided the review: (a) Which approaches to comprehension instruction have been investigated for students with ASD?; (b) Have there been a sufficient number of acceptable studies using a particular strategy to qualify as an evidence-based practice for teaching comprehension across the content areas?; and (c) What can educators learn from the analysis of high quality studies? Of the 23 studies included in the review, only 13 achieved high or adequate ratings. Results of the review suggest that both response-prompting procedures (e.g., model-lead-test, time delay, system of least prompts,) and visual supports (e.g., procedural facilitators) can increase comprehension skills in content areas of ELA, math, and science. Authors conclude with a discussion of (a) research-based examples of how to use effective approaches, (b) implications for practitioners, and (c) limitations and future research.