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This study offers a preliminary investigation of gains in students’ early literacy reading scores when historically Black college or university preservice teachers facilitate letterbox lesson interventions during field clinical experiences with at-risk readers using culturally relevant pedagogy and materials. The aims of this study were to (a) assess overall gains in reading and (b) examine more specific gains in phoneme awareness, letter naming fluency, decoding, and spelling. Using t-test comparisons, results indicate significant gains between the administered pre- and post-reading assessments on phonemic awareness development, letter naming fluency, and spelling abilities. The findings suggest culturally relevant pedagogy combined with clinical letterbox interventions may particularly support the reading achievement of at-risk readers. Additional research is needed to better understand the impact of historically Black college or university preservice teachers’ use of culturally relevant materials and pedagogy and field clinical letterbox interventions with at-risk readers.