This book presents six case studies of student-perpetrated school shootings and discusses possible effective interventions. Between 1992 and 2001, 35 incidents occurred in which students started firing at schoolmates and teachers at their school or at a school-sponsored event. These incidents, including the Columbine High School incident, left 53 dead and 144 injured. These incidents shocked the public because so many were killed in single incidents, the targets seemed arbitrarily selected, and they occurred in such unexpected places. Communities that thought they were insulated from lethal youth violence discovered that they were vulnerable. Congress asked that detailed case studies be developed of the circumstances that led to violence in schools. The goal was to use these cases to learn about the important causes and consequences of such incidents, and to decide what actions could be taken to prevent these events. The consequences of such incidents were significant and there was long lasting harm in each of the communities studied. Those closest to the center of the incidents continue to be traumatized; victims' civil suits against the shooters' families and the schools are still pending; and some businesses continue to suffer because of the harm to the communities' reputations. It was found that these events represented a separate strain of violence even though it followed closely other earlier violence. The inner-city epidemic was fueled by poverty, racial segregation, and illicit drug trade. The violence in suburban and rural schools more closely resembled "rampage" shootings that occurred in places other than schools, such as workplaces. This idea was supported by the differences in the motives of the shooters and the circumstances under which the shootings occurred. The inner-city shootings involved specific grievances between individuals whereas the suburban and rural school shooting cases involved youth that had exaggerated and abstract grievances. There was a spike for all kinds of rampage killings in the late 1990's. Further exploration is needed of the precursors to these incidents, including bullying in schools, illegal gun carrying by adolescents, and mental health problems of youth.