The current review explored effective school-based intervention for children with behavioral difficulties in mainstream primary schools. A search of the literature identified 17 journal articles that investigated a variety of targeted individual and group interventions to address externalizing behaviors. Target behaviors addressed included both promoting positive and reducing negative behaviors. Interventions included antecedent- or consequent-based approaches, behavioral contracts, check-in/check-out strategies, and social-emotional programs. Studies were evaluated and critiqued according to Gough's (2007) "Weight of Evidence" Framework. Convincing support for the effect of intervention on externalizing behavior was found, particularly in terms of outcomes for increased positive behaviors. Intervening to improve positive outcomes for children with externalizing behavior difficulties appears both feasible and economical.