Zero-tolerance school disciplinary policies have contributed to the proliferation of exclusionary practices, which increase the risk that minoritized students will be harmed by the school-to-prison pipeline (STPP). The purpose of this review was to explore factors that influence the STPP and highlight the role school nurses can play in protecting students from this public health crisis. We used a systematic mixed-studies review method, and 14 studies were included. Exclusionary discipline disproportionately affects minoritized students, but decreased student-teacher ratios, wellness-focused environments, and lower levels of school punishment can improve student achievement and health. The National Association of School Nurses position statement provides a framework to guide school nurses in the dismantlement of the STPP. School nurses should advocate for their position on the interdisciplinary team, funding for alternative disciplinary programs, abolition of school policing, restorative justice approaches, support for at-risk students, and anti-racism education programs for all school staff.