This paper examines the impact of high-fatality school shootings on the subsequent outcomes of the survivors of those events. We focus specifically on the shootings at Columbine High School (Littleton, CO), Sandy Hook Elementary (Newtown, CT), and Marjorie Stoneman Douglas High School (Parkland, FL). We assess the subsequent educational record, including attendance and test scores, and the long-term health consequences of surviving students. In all analyses, we treat the timing and location of these events as random, enabling us to identify causal effects. Our results indicate that these high-fatality school shootings led to substantial reductions in attendance and test scores. These educational effects appear to be larger than the effects of shootings with fewer fatalities estimated by others. Children who survived the Columbine shooting were more likely to die by age 30, particularly among boys. They experienced higher levels of suicide and accidental poisonings (overdoses).