Childhood obesity and the early development of type 2 diabetes (T2 DM) place students at risk for chronic health problems. The school nurse is uniquely situated to promote school health initiatives that influence health behavior. The purpose of this review was to determine effective nonpharmacological interventions for prevention of T2 DM in youth. Researchers from 35 reports modified T2 DM risk factors. These nonpharmacological interventions often include increasing daily activity, decreasing caloric intake, and increasing muscle mass. Some researchers also included psychological and social support interventions intended to strengthen initiating and/or maintaining health behavior. Characteristics of effective nonpharmacological T2 DM prevention interventions are discussed. Findings from this review are a useful guide for the implementation of T2 DM prevention strategies in the school setting. Few school-based studies included high school students; therefore, further research is needed among older adolescents on the efficacy of nonpharmacological interventions in the high school.