Purpose: Increasing the depth and breadth of vocabulary knowledge is critical for academic success, particularly for middle and high school students who face ever-increasing linguistic demands with each grade advancement. Implementing effective vocabulary instruction methods that integrate with classroom curricula remains of critical clinical importance for struggling students. This clinical focus article addresses the challenge of contextual vocabulary instruction by presenting semantic reasoning, an evidence-based instructional approach that utilizes both cognitive and linguistic processes. Semantic reasoning pairs critical-thinking, multiple visual examples, and language-based instruction to teach vocabulary words. Conclusions: This article provides a description of semantic reasoning as an evidence-based vocabulary teaching approach that can be used in contextualized language intervention, particularly with adolescent students. Step-by-step guides for preparing and implementing contextualized vocabulary lessons that use semantic reasoning are provided in an effort to promote clinical application of this approach.