Pragmatic language impairments are universal in autism spectrum disorder (ASD) but specifying their exact nature has proven to be difficult. This chapter briefly traces the history of investigation into pragmatic skills in ASD, and reviews current research in three major areas: the development of communicative speech acts, the management of conversations, and the ability to adjust one's language to meet the needs of listeners and situations. More sophisticated discourse such as generating narratives is briefly discussed. In general, speakers with ASD are likely to display problems in all of these areas, but pragmatic profiles vary tremendously from one person to the next. At present, no single constellation of skills or impairments can be considered to be characteristic of ASD. The chapter concludes by mentioning some of the issues that should be targeted in future research.