Background: Although less than 2% of all homicides among young people are school-associated, since 1970 1373 K-12 school gun violence incidents have injured 1403 people and killed another 728. These incidents have changed the education landscape. Informed stakeholders must work together to prevent school gun violence. Methods: We reviewed the nature of school gun violence in the United States and efforts to prevent it. Results: We briefly outline a public health approach to prevent school gun violence, major actions the nation has taken, current school gun violence surveillance systems, the effects of school gun violence nationwide, the extent to which our schools are implementing various interventions to prevent it, and a national strategy to move forward. Conclusions: Our young people and our schools deserve a more organized national effort.