Fractions are an important mathematical concept for elementary students. However, students with mathematics learning disabilities (MLD) struggle with learning fractions. Research has demonstrated that concrete-representational-abstract (CRA) instruction is an effective practice for students with learning and developmental disabilities. Here we investigated whether CRA instruction can support struggling learners' understanding of fractions in China. Using a multiple probe across-students single-case design, we applied CRA instructions to 4 fourth-grade students with MLD. Results showed that CRA instruction improved students' fraction proficiency. Limitations of the study, as well as implications on CRA instruction for elementary students with MLD in practice, are discussed.