Successful completion of organic chemistry is a prerequisite for many graduate and professional programs in science, technology, engineering, and mathematics, yet the failure rate for this sequence of courses is notoriously high. To date, few studies have examined why some students succeed while others have difficulty in organic chemistry. This study examines factors related to student performance in organic chemistry courses. Results indicate that high-achieving students, as measured by course grades, score higher on measures of conceptual performance and problem-solving while seeking assistance and engaging in practice problems earlier in the semester than low-achieving students. Case studies illustrate how students engaging in such behaviors can overcome poor prior grades while those not engaging in such behaviors can perform poorly despite strong prior grades. Overall, study behaviors and conceptual understanding outweigh prior academic standing in predicting final course grades. These analyses suggest potential intervention targets for educators addressing students at risk for poor organic chemistry performance. (Contains 5 tables.)