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This observation study documents content and quality of reading instruction provided to students with intellectual disability and low IQ in grades K-3. Seven special education teachers were observed providing reading to 17 students in self-contained settings. Teachers were then interviewed on their perceptions of research-based reading instruction for students in this population. Findings indicate content extends beyond previously predominant sight word instruction to phonics, comprehension, vocabulary, and text reading. Most instruction was delivered to students working individually with a teacher. Teachers spent large portions of instructional time addressing problem behavior and other academic goals. Low-average to medium ratings of student engagement and instructional quality aligned with previous observation studies of low-incidence populations, as well as sample teachers’ self-report data.