This systematic review of the literature examined available evidence regarding the effectiveness of occupational therapy interventions for improving the reading performance of older adults with low vision. We reviewed 32 studies and found strong evidence supporting low vision programs that included occupational therapy and moderately strong evidence supporting the use of electronic magnification. Moderate evidence supported the influence of illumination on reading ability. Limited evidence was found to support eccentric viewing training and optical magnification. More evidence of higher quality is needed to validate the effectiveness of optical magnifiers, text eccentric viewing, characteristic preferences, and line guides within optical magnification. Additionally, further research is needed to develop a standard low vision rehabilitation program. The results of this review support the need for occupational therapy to be included in low vision rehabilitation. The implications of the findings for occupational therapy practice, research, and education are discussed.