Gifted students with coexisting disabilities, also known as twice-exceptional, are increasingly recognized in America's schools. This increasing awareness needs to be met with equal enthusiasm for empirical investigation into the identification and treatment needs of this group of students. In this article, a 20-year review of the empirical literature examining twice-exceptionality, specifically gifted students with learning disabilities, attention deficit hyperactivity disorder, or autism spectrum disorder, was conducted. Research strongly suggests that gifted students can have a coexisting disability and that comprehensive, individualized approaches toward diagnosis are necessary. Less is known about effective treatments and interventions that simultaneously highlight strengths and accommodate for areas of growth. Future research directions are offered that ideally will encourage scholars to discover more about effective diagnostic and intervention techniques for this very important group of gifted learners. (Contains 3 tables.)