Implementation of Tier 2 or supplemental reading intervention for students who struggle with reading in elementary schools is a nearly universal practice in the United States. Resources exist for assisting schools with selecting evidence-based interventions. However, there are many more explicit and implicit decisions that schools make when implementing evidence-based intervention that may or may not impact the effectiveness of the intervention. In this literature synthesis, we aggregate the decisions made in effective Tier 2 reading interventions to help students improve their reading skills. These decisions include identifying which students would most benefit from specific interventions, how long to schedule intervention time, how to schedule staffing, the types of professional learning supports needed, and decisions based on progress monitoring.