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Although small-group guided reading is traditionally an elementary school instructional practice, this study details how high school English teachers perceived its implementation in high school classrooms. As part of a larger, multiyear research project, this 2-year study examined a dual-level coaching professional learning program that included two school district literacy coaches, eight provincial literacy facilitators, and 21 high school teachers. Teachers were coached in the implementation of guided reading and small-group instruction to support students in Grades 9–10 who were struggling with reading. Qualitative methods were used to gather data including observations of the professional learning meetings and teachers’ instruction; interviews with literacy coaches, professional literacy facilitators, and teachers; and artifact collection. Data were analyzed using the qualitative software program NVivo. The findings suggest that teacher coaching, modeling, co-planning, discussion, and reflection enhanced teachers’ abilities to support students in their use of metacognitive skills and comprehension strategies during guided reading. Teachers noted some insightful instructional considerations for implementation of elementary instructional practices in their high school English classrooms. Overall, these results have practical implications for teachers seeking to help struggling high school readers.