Background: Bullying behavior is a concern among school-aged youth and anti-bullying programs have been implemented in schools throughout North America. Most anti-bullying programs are delivered to adolescent youth because antisocial-aggressive behaviors are typically associated with this developmental stage. This paper is a review of empirically evaluated school-based bullying prevention and intervention programs in North American elementary schools. Methods: We conducted a systematic, critical review of bullying prevention programming. Data were analyzed to determine the study method, intervention components, measurement of bullying, aggression, or peer victimization, outcomes measured, and results. Results: Our review resulted in the identification of 10 interventions aimed at youth in grades K-6 enrolled in North American elementary schools. Effective intervention strategies targeted a variety of bullying behaviors using diverse mechanisms and included a school--and community-wide approach. Direct outcomes of the reviewed evaluations were centered on bullying, aggression, and victimization. Indirect outcomes of review evaluations included strategies for bystanders, school achievement, perceived school safety, and knowledge or attitudes about bullying. Conclusions: Recommendations for promising practices in effective bullying intervention programming are offered. The review concludes with suggestions for supporting school health staff and in-service teachers drawn from the body of research, and offers direction for future study.