Anxiety is a common emotional problem across development. Given that children spend approximately 50% of their waking-hours in school, it is important to consider how anxiety manifests within this setting and the unique difficulties that anxious children may experience while at school. The current paper reviews the impact of anxiety in children at the student, classroom, and district levels. Additionally, recommended treatment approaches at different developmental levels are discussed and secondary outcomes of treatments (i.e., social, emotional, and academic functioning, as well as attendance) are reviewed. Finally, recommendations for the school setting are offered at the universal, targeted, and indicated levels using a response to intervention framework.