School discipline is a salient challenge in K-12 districts nationwide. The majority of prior studies have focused on suspensions with relatively little attention paid to other forms of exclusionary discipline. This mixed-methods study provides a descriptive analysis of overlooked disciplinary consequences, namely, assignment to alternative schools, expulsions, and referrals to hearing. The findings from the quantitative analysis indicate that possession of drugs, student and staff assault, and weapons-related incidents account for the majority of infractions leading to the most severe forms of exclusionary discipline. Black male students account for the largest proportion of students receiving the harshest exclusionary disciplinary consequences. The findings from the qualitative analysis reveal several challenges that policymakers in urban districts navigate regarding alternative schools, including (a) staffing and the development of professional capacity, (b) the length of the school day, (c) transportation, and (d) the choice between in-district versus third-party operation of alternative schools.