For 20 years, "life skills" education has been advocated as a key component of HIV and AIDS education for young people. But what do terms such as life skills imply, and what evidence is there that a life skills-based approach really works? This article reviews the literature on the effects and effectiveness of life skills-based education for HIV prevention. Evaluated interventions were identified by using three search strategies. The review identified a surprising number of rigorously designed and evaluated interventions from Africa, Latin America, Asia, and the Pacific. Most interventions used life skills training as a component of the overall education strategy. Programs worked best to positively influence knowledge, attitudes, intentions, skills, and abilities. Programs rarely produced consistent effects on sexual behavior. Also, life skills, training had little effect on biological outcomes. The narrow focus on achieving behavioral outcomes may be at the loss of documenting other positive impacts.