This metasynthesis presents the collective findings based on a small corpus of studies (n = 28) that examined literacy coaching in elementary and secondary settings from a relational perspective. We frame our analysis using Lysaker's notions of relational teaching and theorize that, like classroom teaching, powerful literacy coaching is grounded in dialogic, co-constructive interactions in which the coach and teacher jointly develop new knowledge and skills. Our analysis indicates that the realization of co-construction may be influenced by differential patterns related to positioning and dispositions toward coaching: (a) knowledge flow, (b) distributed expertise, and (c) vulnerability. To explicate these patterns, we present evidence of opportunities that enhanced co-construction and obstacles that reduced co-construction. We conclude by discussing how coaches and teachers can develop reciprocity in coach-teacher relationships and move toward more relational coaching approaches. Finally, we provide directions for future research.