The purpose of this article is to provide a comprehensive review of school-based suicide prevention programs from a public health perspective. A literature review of empirical studies examining school-based suicide prevention programs was conducted. Studies were required to contain information pertaining to the implementation and outcomes of a school-based program designed to address suicidal behaviors among children and youth. A total of 13 studies was identified. Most of the studies (77%) were classified as universal suicide prevention programs (n 10), with the remaining studies classified as selected suicide prevention programs (n 3). Studies were coded based on key methodological features of the Task Force on Evidence-Based Interventions in School Psychology Procedural and Coding Manual (Kratochwill & Stoiber, 2002). The highest methodology ratings were obtained by two universal suicide prevention programs (Klingman & Hochdorf, 1993; LaFromboise & Howard-Pitney, 1995) and one selected prevention program (Randell, Eggert, & Pike, 2001), although the selected suicide prevention programs demonstrated proportionally more key methodological features than the universal suicide prevention programs. However, only 2 of the 13 studies reviewed demonstrated strong evidence for statistically significant effects on primary outcome measures. Very few studies provided promising evidence of educational/clinical significance (7.6%), identifiable components linked to statistically significant primary outcomes (23.1%), and program implementation integrity (23.1%). Furthermore, no studies provided evidence supporting the replication of program effects. The implications of these results for practice are discussed as well as needs for future research. (Contains 2 tables and 1 footnote.)