Gifted students with relative reading difficulties often struggle with the discrepancy between their high intelligence and lower-than-expected word-reading level (i.e., discrepant readers). This discrepancy may be a burden and poses specific educational challenges to individual students. To understand their challenges and the nature of their discrepancy, this study examined the cognitive profiles of gifted discrepant readers (n = 50) compared with gifted (nondiscrepant) readers (n = 30). A case series analysis mapping weaknesses and strengths on risk factors for dyslexia (phonemic awareness [PA], rapid automatized naming [RAN], and verbal short term memory [VSTM]) showed that both groups displayed largely similar cognitive profiles. A discrepant reading profile seemed to result from the absence of strengths on underlying skills (PA, RAN, VSTM). Hierarchical multiple regression indicated that group (discrepant readers vs. gifted readers) did not moderate the relationship between cognitive factors and word-level reading outcomes. Based on these findings, it is proposed that educational support for gifted discrepant readers might comprise gifted- and needs-based education that focuses on (building) strengths.