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This article makes the conceptual and empirical case for using acceptance and commitment therapy (ACT) with youth in school settings. As background, a logical, evidence-based case is made for school-based mental health services more generally. The authors outline a public health approach to using ACT in schools via a multitiered system of supports (MTSS), which emphasizes scaled prevention at universal, targeted, and intensive levels. In addition, the existing literature on ACT in schools is reviewed, showing adequate evidence to support use at the targeted level. The limitations and challenges of using ACT in schools are discussed, and future directions for advancing research and practice are offered. Future work in this area might especially benefit from (1) enhancing the methodological rigor of research designs in school-based studies,(2) testing the viability of brief or focused ACT at the targeted level in …