School leaders in the 21st century must negotiate a number of competing demands, working as managers as well as instructional leaders. However, with the onslaught of high-stakes accountability measures and increased expectations for student achievement, the principal as instructional leader emerges as a critical role. Educational leadership literature suggests that principals indeed have an impact on student learning outcomes, albeit indirectly. Particularly for elementary school principals, instructional leadership practices that support reading achievement are a high priority since early literacy skills serve as a foundation for future learning in all content areas. Principals leading for reading achievement attend to many aspects of a comprehensive literacy program that is responsive to students’ evolving needs. One aspect of a comprehensive literacy program is a structured approach to addressing the needs of struggling readers who need additional supports and may require more specialized, targeted instruction. The Targeted Reading Intervention (TRI) is a type of support that individualizes instruction for struggling readers. The researcher used a mixed methods approach to investigate the instructional leadership practices associated with principals whose schools made significant gains after implementing TRI. A conceptual framework consisting of five themes of leadership actions served as a lens through which to analyze the leadership practices of ten elementary school principals in three rural districts in the southeastern United States. After ranking principal leadership practices using the themes, the researcher compared the principal leadership practices to school gains in an effort to identify which practices were likely to have influenced the greatest gains.