Effective education reform depends on its successful realization by the school leadership carrying out the reform. School principals and middle leaders in the 21st century re-examine their traditional role so as to understand complexities and ambiguities characterizing their various responsibilities within the context of school reform. As critical change agents and system players, formal leaders interpret reform demands and translate them into school practices through a process of sense-making. Though sense-making is an ongoing process that school leaders undergo personally and collectively during policy reforms, little attention has been paid to the role principals and middle leaders perform as sense-makers. This literature review article explores sense-making in school leadership through a holistic approach. It demonstrates how sense-making is framed in both theoretical and empirical studies as well as suggests implications and avenues for future research.