Background: Since 1984, Students Taking a Right Stand (STARS) Nashville has implemented Student Assistance Programs (SAPs) in the middle Tennessee area, to include 14 counties and 16 school districts. STARS Nashville serves K-12 with a focus in middle and high schools. Methods: The current study reviewed studies that utilized quasi-experimental and experimental study designs, together with cross-sectional surveys to report the effectiveness of STARS Nashville SAPs. Results: STARS Nashville SAP has shown statistical significance in promoting positive attitudes toward non-use of alcohol and other drugs and non-rebelliousness and decreased alcohol and other drug use among students. Additional evaluation data indicate that STARS Nashville SAPs have reduced suspension (including violence-related suspension), improved attendance, improved grades, and prevented dropping out of school. Conclusions: STARS Nashville has demonstrated success among Hispanic and Asian ethnic groups and is most effective with Caucasian and African-American populations.