Only 25% to 38% of secondary education graduates in the United States are proficient readers or writers but many continue to postsecondary education, where they take developmental education courses designed to help them improve their basic academic skills. However, outcomes are poor for this population, and one problem may be that approaches to teaching need to change. This chapter discusses approaches to the teaching of academically underprepared postsecondary students and how teaching might be changed to improve student outcomes. A wide variety of approaches is reported in the literature, including teaching of discrete skills, providing strategy instruction, incorporating new and multiple literacies, employing disciplinary and contextualized approaches, using digital technology, and integrating reading and writing instruction. However, the field has yet to develop a clear theoretical framework or body of literature pointing to how teaching in this area might improve. Based on our reading of the literature, we recommend directions for future research that could inform changes in the teaching of underprepared students at the postsecondary level.