Students with or at-risk for emotional disturbance (ED) frequently receive interventions that include a direct manipulation of consequences. The ability of educators to identify reinforcing stimuli that may function as powerful consequences determines the success of reinforcement-based strategies. Choice-based stimulus preference assessments provide a systematic means of identifying potential reinforcers that have been well researched with children and adults with severe disabilities. However, research concerning the effectiveness of choice-based stimulus preference assessments for students with ED remains limited. Therefore, the current literature review examines the experimental context and effectiveness of choice-based stimulus preference assessments in identifying reinforcers for students with ED in educational settings and the advantages of these procedures over preference surveys. While reinforcers identified through choice-stimulus preference assessment increased the target behaviors of the participants, choice-based preference assessment methods did not unequivocally improve upon preference surveys. Implications for practitioners and future research directions are discussed.