After conducting over 200 interviews and reviewing thousands of pages of records and reports, the Virginia Tech Review Panel presented several findings. Highlights of these findings include: (1) Senior Seung Hui Cho exhibited signs of mental health problems during his childhood through high school and in 1999 was observed with suicidal and homicidal ideations; (2) due to lack of resources, incorrect interpretation of privacy laws, and passivity, there was a failure in providing Cho with needed support and services in late 2005 and early 2006; (3) Virginia’s mental health laws are flawed and services for mental health users are inadequate; (4) Virginia is one of only 22 States that report any information about mental health to a Federal database used to conduct background checks on would-be gun purchasers; (5) the Virginia Tech Police Department erred in not requesting that the Policy Group issue a campus-wide notification that two persons had been killed and that everyone should be on alert; (6) State systems for rapidly deploying trained professional staff to help families attain resources did not work; and (7) Virginia colleges and universities need to work together as a coordinated system of State-supported institutions. Recommendations are proposed, discussed, and based on the lessons learned from the events of April 2007. The Virginia Tech Review Panel, commissioned by Virginia Governor Tim Kaine, was tasked with reviewing the events of April 16, 2007, the killing of 32 and injuring of 17 students and faculty on the campus of Virginia Tech, and assessing the actions taken and not taken, identifying lessons learned, and proposing alternatives for the future. In addition, the panel reviewed the emergency response by all parties and the ensuing aftermath. Appendixes A-N