This systematic scoping review reports findings from 38 studies (2000–2022) that explored the approaches to differentiation that have been effectively used with high-ability students and the school-level supports that enabled their application. The review advances our understanding of current approaches and highlights future considerations for school-based pedagogies that aim for an inclusive education for all, including shared understandings of what effectiveness means and looks like in practice and how it can be determined or measured. The review identified 15 effective teaching approaches used with high-ability learners, showing that teachers draw upon an array of approaches when differentiating for high-ability students in both primary and secondary settings and across disciplines. However, the limited number of studies and predominance of data from one country suggest the need for further research across a broader range of contexts, including the important role of school leadership in supporting differentiated teacher practice. This need is made more pressing in contexts where differentiation continues to be primarily focused upon students working below expected level rather than including the highly able, and where the practice of differentiation continues to be misunderstood.