This article is a review, its main goal is to investigate the current state of knowledge regarding word meaning understanding by individuals with autism. Issues of reference, scope (denotation), meaning structure, semantic features, and ambiguity are discussed. The analysis revealed that people with ASD have skills developed to varying degrees that allow them to acquire and use words. At the same time, certain aspects of meaning and explicit word knowledge may be limited to varying degrees. Interpreting the results of research on the semantic-lexical skills of individuals with ASD requires caution, taking into account the specificity of the subject and object of the study, the theoretical foundations, methodological considerations, and the research context. Further research on word comprehension by individuals with ASD is needed. Speech therapy assessment of individuals with ASD must take semantic-lexical skills into account. Effective therapeutic interventions should aim to improve word meaning understanding, tailored to individual needs, which requires implementing approaches, methods, and strategies that allowing the development of meaning in all its relevant dimensions.