•Incorporating extended conversations into video-based story retelling improves oral narratives in adolescents with ID.•The Story Hand, a novel visual support strategy, is feasible in story retelling.•The intervention is highly effective for improving MLU-M, NDW, and the complexity of story grammar.•This study adds evidence concerning the possibility of continued growth in oral narrative language for adolescents with ID. Oral narrative language is a persistent area of language difficulty for individuals with intellectual disability (ID). This study aims to explore the effectiveness of a comprehensive intervention program that incorporates extended conversations into video-based story retelling instruction with a novel visual support strategy, Story Hand, to develop oral narrative skills in adolescents with ID in China. Using a single-case multiple-probe across participants design, the researchers examined whether the comprehensive intervention program could improve participants’ oral narrative skills both microstructurally and macrostructurally. All three participants demonstrated moderate to high treatment effects in the microstructural narrative outcomes (i.e., the mean length of utterance in morphemes MLU-M and the number of different words NDW) and one of the macrostructural narrative outcomes (i.e., the complexity of story grammar SG-complexity) in response to the comprehensive intervention program, and these acquired effects were maintained at a high level for up to one month. However, all three participants demonstrated limited treatment effects in one of the macrostructural narrative outcomes (i.e., cohesion) in response to the comprehensive intervention program. The comprehensive intervention program that incorporates extended conversations into visually supported video-based story retelling instruction offers an option for teachers to develop oral narrative skills in adolescents with ID. However, the relative effectiveness of the different components of the intervention needs to be further explored.