This systematic review focuses on research articles published since 1980 that assess outcomes of narrative-based language intervention for preschool and school-age children with language impairment. The author conducted a comprehensive search of electronic databases and hand searches of other sources for studies using all research designs except nonexperimental case studies. The results of the studies were converted to a common metric using effect sizes. The review yielded nine studies that met inclusion criteria. The majority of studies reported moderate to large effect sizes for narrative macrostructure and microstructure. Although the results of the studies were generally positive, each of the studies had a limited number of participants, limited experimental control, and considerable variation in the procedures and materials used. Clinicians should be cautious when interpreting the results of these studies. Narrative intervention is at an emerging stage of evidence and needs further investigation.