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The issue of school violence and antisocial behavior in public schools is, in fact, one of the most pressing concerns in education today. Schools have responded by designing, implementing, and evaluating multi-level models with progressively more intensive levels of support. The foundation of these models is the primary, or universal, prevention program. To date, most investigations have occurred in elementary schools thereby providing limited insight into intervening in secondary schools. This chapter reviews the literature base of school-wide interventions with primary level efforts conducted in secondary schools with an emphasis on methodological considerations. Content includes the findings of a systematic literature review, a discussion of quality indicators in relationship to primary prevention efforts, and recommendations for future inquiry.