Observation research can shed light on the degree to which students have access to research-based instruction and intervention. In this systematic review of reading observation research for students with and at risk for emotional and behavioral disorders, we sought to identify trends in the settings and student populations investigated and research methods used, as well as to determine the degree to which this student population has access to research-based reading instruction. Eleven studies meeting selection criteria were identified and coded to extract information that was salient to research questions. Although the extant observation research is limited, findings suggest that concerns raised by (Vaughn et al., Journal of Special Education 36:2-13, 2002) approximately 18 years ago remain. Study limitations, implications for school practice, and areas for future research are discussed.