Abstract Background The American Academy of Pediatrics regards literacy promotion as essential. Medical professionals are in a key position to promote children's early literacy, however this requires knowledge of existing literacy programmes. This study describes medical student training, awareness, experiences, and attitudes towards early literacy and the ‘Reach Out and Read’ (ROR) initiative. Methods An anonymous online survey was sent to all medical students at a medical school in the Midwest with two campuses. Data were analysed using descriptive statistics. Results We received data from 275 medical students. Almost half (46.5%) had completed their paediatric clerkship, 22.9% had observed ROR, and only 2.9% had received any training. Most (67%), wanted to learn more about early literacy, and 59% expressed a desire for more ROR training. Most respondents expressed preference for learning from residents and faculty in clinic followed by online training. 47% agreed that it was a role of medical students to assess and encourage reading. Discussion Medical students understand the importance of early literacy in primary care and emphasising this during clinical encounters. Most are eager to learn more about early literacy promotion and ROR. This interest decreases during third and fourth year so targeting the first 2 years of medical school is an important strategy. Providing formal literacy promotion training and education for medical students should be considered during this critical time in their education.