Physical restraint is a restrictive practice used in schools across the UK and there have been recent concerns around the appropriateness and frequency of using this intervention with pupils. Current data suggest that pupils with Special Educational Needs (SEN), a vulnerable and diverse group, are experiencing the majority of physical restraint used in educational settings. Physical restraint can lead to negative emotional and physical consequences in pupils who experience it and it is, therefore, important to explore alternative strategies to reduce or eliminate its use in educational settings. A systematic literature search found 15 studies (date range 1999-2019) that explored the effectiveness of school-wide or individual approaches in reducing the frequency and/or duration of physical restraint. Most studies saw a significant decrease in physical restraint, and this study will discuss the key elements of the successful approaches, as well as consider the facilitators and barriers to implementation.