<p>Structured language interventions are increasingly recognized as effective tools for supporting young children’s oral language development. However, implementing such interventions in Nordic early childhood education and care (ECEC) settings – anchored in play, child autonomy, and holistic development – presents distinct challenges. This narrative review synthesizes eight intervention studies from Nordic ECECs to consider how structured language support can align with Nordic pedagogical values. We first outline implementation concepts – fidelity, readiness, alignment – and how they intersect with this context. We then summarize interventions ranging from highly scripted, small-group programs to broader curriculum models. Across studies, interventions that targeted children at risk, used small-group formats, and emphasized expressive language were more often associated with positive short-term gains; however, effects frequently faded without sustained support. At the same time, rigid scripting can conflict with professional autonomy, and broad play-based models often lack sufficient instructional focus to yield measurable language outcomes. We identify five recurring dilemmas – alignment with Nordic traditions, scripting versus autonomy, differentiation, implementation capacity, and sustainability – and propose practice-oriented pathways: modular design, co-development with educators, and stronger preschool–school continuity. Because key features (targeting, format, dosage, professional development, fidelity) co-vary across studies, these patterns should be interpreted as associations rather than mechanisms.</p>