Improving coherent monologue speech is of key importance in the overall development of speech in preschoolers. The problem that we consider in our study is the examination of the specific aspects of coherent monologue speech development in preschool children with general speech underdevelopment and planning of a correctional and developmental process using fairy tales, taking into account their specific speech development. The purpose of the article is to justify the practicability and effectiveness of using fairy tales in speech therapy work for the development of monologue speech in preschool children with general speech underdevelopment. Diagnostic results using V.P. Glukhov’s method indicate that children in this category have a low level of coherent monologue speech development, which emphasizes the relevance and significance of the study. The article reveals the essence of speech therapy work aimed at improving monologue speech in preschool children with general speech underdevelopment through the use of fairy tales.