Rational number proficiency is predictive of later mathematics achievement, especially for rigorous mathematics courses, such as Algebra I. Students with learning disabilities (LD) in mathematics struggle to make adequate progress on rational number concepts and skills that lay the foundation for successfully completing secondary mathematics courses. However, recent research has demonstrated that utilizing effective instructional design, such as the use of a number line with systematic and explicit instruction, can result in academic progress for students with LD in mathematics. This article presents teachers with a four-step teaching sequence utilizing the number line and effective strategies for teaching students with LD in mathematics to introduce fraction-to-decimal relationships in upper elementary, a prerequisite for middle school mathematics.