During the last decade, positive behavior interventions have resulted in improvement of school behavior and academic gains in a range of school settings worldwide. Recent studies identify sustainability of current positive behavior intervention programs as a major concern. The purpose of this article is to identify future direction for effective implementation of positive behavior interventions based on a comprehensive review of the current status of positive behavior interventions in terms of sustainability. The review will also examine implementation fidelity, as a factor that impacts upon sustainability. Literature reviewed in this study demonstrates that administrator support and professional development were the most frequently cited influential factors in previous research on sustainability of positive behavior interventions. In particular, the review highlights the significance of implementation fidelity at the classroom level for sustaining positive outcomes of positive behavior interventions over time. It is argued that in order to sustain positive effects of positive behavior intervention, future implementation efforts need to emphasize administrator support for the school team, ongoing high-quality professional development, and technical assistance. Moreover, a focus on coaching classroom-level implementation fidelity is of significant importance, as is the development and validation of evaluation tools for sustainability based on large-scale longitudinal international studies and more in-depth qualitative investigations.