The middle and high school years represent a unique challenge for students who have not yet attained proficiency with word reading. By this time, it is generally expected that students will be able to independently read a variety of texts to gain content knowledge and to read for understanding. Students with or at-risk for learning disabilities (LD) often struggle with acquisition of word-level reading skills and these difficulties are amplified as words become increasing complex. By fifth grade, most of the new words introduced in text are multisyllabic, yet students often lack a systematic approach for decoding these words. Despite these challenges, teachers "can" effectively support secondary-aged students with LD in developing the foundational word reading skills necessary for reading proficiency. In this article, we describe the critical role of word reading efficiency, unique challenges of multisyllabic word reading, and the importance of ongoing instructional support for students with LD. We then introduce four instructional routines that can be implemented to facilitate secondary students' acquisition of word-level reading skills that also affirm and strength students' diverse cultural and linguistic backgrounds.