The authors report the effects of a yearlong, very small-group, intensive reading intervention for eighth-grade students with serious reading difficulties who had demonstrated low response to intervention (RTI) in both Grades 6 and 7. At the beginning of Grade 6, a cohort of students identified as having reading difficulties were randomized to treatment or comparison conditions. Treatment group students received researcher-provided reading intervention in Grade 6, which continued in Grade 7 for those with low response to intervention; comparison students received no researcher-provided intervention. Participants in the Grade 8 study were members of the original treatment (N = 28) and comparison (N = 13) conditions who had failed to pass a state-mandated reading comprehension test in both Grades 6 and 7. In Grade 8, treatment group students received a 50-minute, daily, individualized, intensive reading intervention in groups of two to four students per teacher. The results showed that students in the treatment condition demonstrated significantly higher scores than comparison students on standardized measures of comprehension (effect size = 1.20) and word identification (effect size = 0.49), although most continued to lack grade-level proficiency in reading despite 3 years of intervention. Findings from this study provide a rationale for intensive intervention for middle school students with severe reading difficulties.