This is the first systematic review of the school outcome literature for behavior interventions used with middle school students exhibiting disruptive behaviors. A total of 51 investigations (published between 2000 and 2020) including 6,498 students and 264 implementers were coded on four dimensions (i.e., sample, interventions, methodology, and outcomes). This review examined intervention effects on implementer and student outcomes, yielding small to large positive effects. Strengths of the reviewed studies included the specification of student characteristics, operationalization of implementers' professional development, and assessment of intervention fidelity. Most studies used single-case designs or randomized controlled trial experimental designs to evaluate the effectiveness of the interventions. Weaknesses included an absence of student diagnostic information; lack of data on implementers, attrition, and follow-up; and inadequate use of parent involvement. School practitioners should be mindful of developmental challenges and consider targets and barriers to implementation. Additional large-scale, rigorous experimental designs are warranted. [For the corresponding grantee submission, see ED614238.]