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This study aims to explore how image-text relationships affect students’ multimodal reading comprehension from a textual perspective. Semi-structured interviews with 40 students revealed the multifaceted role of different modalities. For the image-text relationships, it was noted that illustration and elaboration relationships were relatively easy and the extension relationship was relatively difficult. Nevertheless, the complexity of image-text relationships is not absolute; each type presents its own accessibility issues and unique challenges. This study offers a theoretical framework for a deeper understanding of how image-text combinations influence reading comprehension and provides valuable insights into the flexible integration of various image-text relationships in the development of multimodal reading resources.