Treatment of nonsuicidal self-injury (NSSI) among adolescents within a school setting poses unique and specific challenges. Further, schools vary in resources available to students, and school psychologists differ in training regarding interventions for youth who self-injure. Currently there are no evidence-based approaches to the assessment and treatment of NSSI in the schools. To address this gap, the present article critically reviews the treatment literature for NSSI among both adults and adolescents in clinical and community settings and extrapolates the common elements of effective treatment that could be feasible within schools. Following this, a description of recommended approaches to assessment, triage, and service provision within schools is provided. Finally, three contrasting cases illustrating the use of these different elements are presented and relevant resources and links provided.