Early childhood mental health consultation (ECMHC) is a framework that continues to expand as students' social-emotional needs emerge at younger ages. The present systematic review examines the extant literature surrounding the use of ECMHC and behavioral consultation in addressing mental health concerns and challenging behaviors in preschool students. Findings associated with this systematic review suggest that ECMHC could be a promising practice for targeting internalizing and externalizing behavioral concerns in prekindergarten students across a variety of settings. However, more research is needed in the areas of mental health/behavioral consultation and disciplinary disproportionality, as well as on the impact of such practices on preschool children of color. Implications for school psychologists are discussed, as are disciplinary practices when providing ECMHC and behavioral consultation services with students of diverse racial, ethnic, and cultural backgrounds.