The purpose of this qualitative study was to investigate how primary school teachers use text and images in picture books to support students' reading comprehension. The study aimed to answer the questions: In what ways do primary school teachers utilize text and images in picture books to support students' reading comprehension? What constitutes a successful didactic approach with picture books to support pupils' reading comprehension? The study's data material was collected through six semi-structured interviews at two schools. The empirical material was transcribed and then analyzed through a deductive thematic analysis. The concepts of modality, meaning-making, support and the proximal zone of development formed the basis of the analysis. Seven themes were then created in order to answer the study's question. The results showed that picture books contain a text and image interplay that can support students' reading comprehension. The important role of the image was considered central to the understanding of the text and thus to a complete understanding of the story. The results showed that the main methods the respondents stated were reading aloud, book talks and picture walks, where the modalities were treated together to support the students' understanding. In conclusion, the result showed that the picture book was used as a tool for differentiation, where the images could both support with their presence, and challenge with their absence.