Reading fiction for pleasure is robustly correlated with improved cognitive attainment and other benefits. It is also in decline among young people in developed nations, in part because of competition from moving image fiction. We review existing research on the differences between reading or hearing verbal fiction and watching moving image fiction, as well as looking more broadly at research on image or text interactions and visual versus verbal processing. We conclude that verbal narrative generates more diverse responses than moving image narrative. We note that reading and viewing narrative are different tasks, with different cognitive loads. Viewing moving image narrative mostly involves visual processing with some working memory engagement, whereas reading narrative involves verbal processing, visual imagery, and personal memory (Xu et al., 2005). Attempts to compare the two by creating equivalent stimuli and task demands face a number of challenges. We discuss the difficulties of such comparative approaches. We then investigate the possibility of identifying lower level processing mechanisms that might distinguish cognition of the two media and propose internal scene construction and working memory as foci for future research. Although many of the sources we draw on concentrate on English-speaking participants in European or North American settings, we also cover material relating to speakers of Dutch, German, Hebrew, and Japanese in their respective countries, and studies of a remote Turkish mountain community.