Improvisation is an area of interest to both music education researchers and music educators alike. The purpose of this literature review was to examine extant studies related to improvisation at the elementary level. Selected research included the nature of improvisation, the amount of instructional time and activity type used, the development of improvisation skills with age, and the effect of improvisation on other skill areas. Findings indicated that children chose their own musical and social roles when there was minimal teacher intervention. Most teachers agreed that improvisation was important, although at varying degrees and based on varying levels of experience and ability. Improvisation skills increased with age, particularly when considering rhythmic improvisation and phrase structure, and improvisation was found to increase creativity and divergent thinking while also reducing performance anxiety. Research findings are included from the United Kingdom, Sweden, Finland, Italy, Greece, Slovenia, Malaysia, and the United States. The review concludes with implications for practice and recommendations for further research.