School attendance is an ongoing concern for administrators, particularly in middle level and high school. Frequent absences affect student learning, test scores, and social development. Absenteeism is often the result of emotional disorders, such as anxiety or depression. Administrators who understand the causes of school refusal behavior and are aware of effective intervention strategies can help provide supportive school environments that lead to improved attendance and school outcomes. This article discusses the causes of school refusal behavior and the interventions and treatment for this behavior.