This study aimed to develop, implement, and evaluate an RME-supported instructional design for primary school students with MLD risk who had difficulty in multiplication at the third-grade level. In this study, a design-based research method was utilized since it was aimed to apply and assess the RME-supported instructional design to primary school students with MLD risk. The study selected the participants from primary school students with mathematics learning difficulties who had difficulty in number concepts and operations with natural numbers at the third-grade level. Participant students were determined using the criterion sampling method. As data collection tools, the Numbers and Operations Mathematics Achievement Test (NOMAT), Learning Disabilities Symptom Screening Test, curriculum-based assessment, interview, and researcher diary were used. The content analysis method was used to analyze the data obtained from qualitative data collection tools. Descriptive statistics methods were used to analyze the data obtained from quantitative data collection tools. The data obtained from the research are presented under three themes: findings on analysis, design, and development, findings on implementation, and findings on evaluation. The research results show that teaching with RME-supported instructional design is effective in students' multiplication instruction and contributes to their permanent learning.