Paraeducators are increasingly tasked with delivering early literacy instruction to students with disabilities in elementary schools. This review synthesized findings from 19 studies that examined paraeducator-implemented early literacy instruction and reported the included studies' descriptive characteristics, methodological quality, and treatment outcomes. Studies were rated for methodological quality using the Council for Exceptional Children's quality indicators. This systematic review was the first to describe paraeducator-implemented early literacy instruction in elementary school settings across single-case research designs and between-group research designs and the first to apply a set of quality indicators to rate study quality. The synthesized evidence suggests that, with the appropriate training and supervision, paraeducators were able to facilitate student acquisition in phonological knowledge, word reading, fluency, comprehension, and spelling domains. Implications for research and practice are discussed.