This review comprehensively explores the integral role of explicit metadiscourse instruction and language proficiency and content familiarity in the context of reading comprehension among learners of English as a Foreign Language (EFL). Drawing upon a wide-ranging analysis of empirical studies spanning two decades (2003-2023), the review illuminates the intricate dynamics between these key components. It underscores how metadiscourse markers, as vital linguistic devices, significantly impact the learners' processing, comprehension, and retention of information. The importance of language proficiency emerges as a decisive factor, shaping the degree to which EFL learners can effectively utilize metadiscourse markers to enhance their reading comprehension skills. Moreover, the review accentuates the critical synergistic relationship between content familiarity and the efficacy of metadiscourse instruction, shedding light on how prior knowledge can optimize learning outcomes. It identifies significant gaps in existing research, emphasizing the need for a more integrated approach that simultaneously considers metadiscourse instruction, language proficiency, and content familiarity. The review concludes by advocating for greater emphasis on explicit metadiscourse instruction in EFL pedagogy, positioning this work as a synthesis of current knowledge and a guidepost for future research and instructional innovation in EFL reading comprehension.