Letter orientation confusions (reversals) in the reading and writing of 10-year-old children with and without reading disability were investigated to determine whether reading disability is associated with letter orientation errors and to identify the nature of the errors. In a variety of tasks measuring letter orientation confusions in reception (reversal detection and recognition) and production (controlled writing, copying), individuals with reading disability made more orientation confusions than average readers. Orientation errors were more frequent for reversible than for nonreversible items in tasks involving long-term memory processes. The results did not appear to be related to group differences in attention or speed of motor responding. Possible sources of orientation confusions, including deficient magnocellular system processing, mislabeling, and overreliance on visual strategies, are discussed.