The existence of a necessary association between phonological awareness (PA) and oral reading development has been questioned using evidence from children with Down syndrome. In this study, 22 children with Down syndrome (between the ages of 6;7 and 10;3) initially completed tests of receptive language, cognitive function, oral reading, and PA. Reading and PA were reassessed approximately 9 months later. Better oral reading was associated with superior phoneme segmentation skills on reassessment. Furthermore, there was some evidence that early segmentation ability predicted later nonword reading, but not the reverse. The results indicate an association between PA and early oral reading ability in children with Down syndrome and are interpreted within a theoretical view of reading development in which PA plays a central role.