In this article, we provide a summary of a literature review conducted to determine how the published literature, including research articles, conceptual articles, and chapters, (a) describes access to the state-adopted grade-level standards in general education classes for students with extensive support needs (ESN) and (b) discusses recommended processes for determining meaningful access to the state-adopted grade-level standards in general education classes for students with ESN. We reviewed a total of 554 pieces of published literature considered for inclusion in our summary. Based on our inclusion and exclusion criteria, we included 32 articles and chapters in the final analysis. The review yielded important information related to six themes, including (a) the language used to describe students with ESN; (b) the varying understandings, or perceptions, of what access to the state-adopted grade-level standards means; (c) the recommended steps in the processes that teams might use to provide access to the state-adopted grade-level standards, and the alignment between standards and Individualized Education Program goals; (d) the short- and long-term outcomes of access to and inclusion in the general education curriculum; (e) who is involved; and (f) the ways in which progress monitoring and assessment were implemented. We conclude with our recommendations for future research.