Although substantial evidence demonstrates the effectiveness of augmentative and alternative communication (AAC) intervention for students with severe disabilities who have complex communication needs, increasing importance is being placed on understanding how to move research into practice. This descriptive qualitative study focused on understanding the views of 19 parents and professionals (i.e., special education teachers, paraeducators, and speech-language pathologists) related to factors impacting intervention and outcomes for students with complex communication needs. Within an implementation science perspective, analysis involved applying ecological systems theory to understand factors across systems acting as challenges or facilitators to effective AAC intervention and to outcomes more broadly for students with complex communication needs. Findings produce insight into the ways student-related and micro-, meso-, macro-, and exosystem factors impact intervention implementation and outcomes, highlighting the importance of cross-cutting factors associated with AAC access, family-school partnerships and supports, and inclusive education. Implications for research and practice are discussed related to how these findings can be used to bridge the gap between research and practice for students with complex communication needs.