This experiment examined the item-level relationship between 7-year-olds’ ability to read words aloud and their knowledge of the same words in the oral domain. Two types of knowledge were contrasted: familiarity with the phonological form of the word (lexical phonology), measured by auditory lexical decision, and semantic knowledge, measured by a definitions task. Overall, there was a robust relationship between word knowledge and reading aloud success. The association was stronger when words contained irregular spelling–sound correspondences. There was no evidence that a deeper or more semantic knowledge of words was more closely related to reading aloud success beyond the association between reading success and familiarity with the phonological form of the same words. This finding is not compatible with models that see semantics as contributing directly to the reading aloud process, at least during the relatively early stages of reading development. More critical was whether or not a word was considered a lexical item, as indexed by auditory lexical decision performance.