Research on autism spectrum disorders (ASD) has rapidly expanded in recent years, yielding important developments in both theory and practice. While we have gained important insights into how children with ASD differ from typically developing (TD) children in terms of phenotypic features, less has been learned about if and how development in ASD differs from typical development in terms of underlying mechanisms of change. This article aims to provide a review of processes subserving lexical development in ASD, with the goal of identifying contributing factors to the heterogeneity of language outcomes in ASD. The focus is on available evidence of the integrity or disruption of these mechanisms in ASD, as well as their significance for vocabulary development; topics include early speech perception and preference, speech segmentation, word learning, and category formation. Significant gaps in the literature are identified and future directions are suggested. Autism Res 2016, 9: 810–828. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.