Because high stakes are now attached to standardized assessments of student progress, policy makers, administrators, practitioners, and parents must understand how to most effectively and accurately measure the performance of all students, including students with learning disabilities (LD). To accomplish this, test accommodations are provided on an individual basis that are intended to mediate the impact of a student's disability. The purpose of this article was to examine policy and guidelines related to accommodations among states and to review research related to the effectiveness of accommodations for students with LD. Findings showed that there continues to be large variability among states regarding allowed testing accommodations and that although there has been an increase in research conducted related to the effectiveness of accommodations for students with LD in the past decade, empirical evidence remains sparse and findings are often inconclusive. Implications are discussed.