Bullying is a public health issue that persists and occurs across several contexts. In this narrative review, we highlight issues and challenges in addressing bullying prevention. Specifically, we discuss issues related to defining, measuring, and screening for bullying. These include discrepancies in the interpretation and measurement of power imbalance, repetition of behavior, and perceptions of the reporter. The contexts of bullying, both within and outside of the school setting (including the online environment), are raised as an important issue relevant for identification and prevention. The role of medical professionals in screening for bullying is also noted. Prevention and intervention approaches are reviewed, and we highlight the need and evidence for social architectural interventions that involve multiple stakeholders, including parents, in these efforts. Areas in need are identified, such as understanding and intervening in cyberbullying, working more specifically with perpetrators as a heterogeneous group, and providing more intensive interventions for the most vulnerable youth who remain at risk despite universal prevention efforts.