Following the methodological approach of the International Cochrane Collaboration, this study attempted to find all published and unpublished studies that were relevant and were of sufficient methodological quality. These studies were then evaluated rigorously by two or more Cochrane reviewers, and the results were incorporated into the Cochrane Collaboration Database of Systematic Reviews. Psychosocial interventions were defined as those that aimed to develop psychological and social skills in youth that would enable them to resist peer and social pressures to misuse alcohol. Educational interventions were defined as those that aimed to raise awareness of the potential dangers of alcohol abuse, so that youth would avoid alcohol misuse in their own best interests. In order to identify evaluations of such programs, a comprehensive search of 22 databases was conducted, along with reviews of bibliographies. The focus of the search was on randomized and nonrandomized controlled trials and interrupted time-series studies. The main outcome measures involved in the evaluations were objective or self-report measures of alcohol use and abuse. A total of 56 studies were selected for inclusion in the systematic reviews. Of these 56 studies, 20 were found to be ineffective. Although no clear conclusions could be drawn about the effectiveness of the prevention interventions over the short-term and medium-term, over the longer term (greater than 3 years), the Strengthening Families Program (SFP) showed promise as an effective prevention intervention. Other interventions with promise were culturally focused interventions that involved skills training over the longer term. Community interventions were valuable because of their inclusion of the wider community in efforts to prevent alcohol abuse by youth. This paper recommends that research into important outcome variable be undertaken; that the methodology of evaluations be improved; that the SFP be evaluated on a larger scale and in various settings; that culturally focused intervention undergo further development and rigorous evaluation; and that an international register of alcohol and drug misuse prevention interventions be established and uniform criteria be determined for rating prevention interventions in terms of safety, efficacy, and effectiveness. 4 tables and 75 references