This study investigated effects of reading medium (print vs. digital) on integrative processing and integrated understanding of an illustrated text on human sexuality, as well as whether reading medium indirectly affected integrated understanding via integrative processing. Participants were 100 undergraduate and graduate students in educational sciences. Integrative processing was indicated by participants' gaze transitions between complementary textual and pictorial parts of the document during reading, and integrated understanding was indicated by participants' integration of textual and pictorial information in post-reading written responses. Results showed that participants who read the illustrated text on paper displayed more integrative processing during reading than did participants who read exactly the same text on a computer. In turn, integrative processing positively affected comprehension performance, resulting in a mediated effect of reading medium on comprehension via integrative processing. There was no main effect of reading medium on integrated under- standing, however. Also, prompting participants to pay attention to both text and illustration as well as their relationship did not have any main effects on integrative processing or integrated understanding; nor were there any interaction effects of reading medium with instructional prompt on integrative processing or integrated understanding. These results are discussed in terms of the insights they offer into reading medium effects on processing and comprehension, as well as in terms of the directions they suggest for future research in this area.