Several multiwave cross-national surveys have experienced drops in school participation for youth health and risk behavior (HRB) surveys in Western European countries. This article considers explanations for the challenge in recruiting schools for surveys in England, Germany, the Netherlands, and the United States and the most important lessons learned during school recruitment for the third wave of the International Self-Report Delinquency Study in these four countries. Comparing school response rates for international academic surveys with those focused on HRB, schools have been increasingly less likely to participate in HRB surveys over the past two decades. However, considerable variation within and across surveys and countries suggests there are numerous influences on school recruitment, and there may be facilitators on which researchers could capitalize. We conclude that when planning future school-based HRB surveys, researchers should consider multiple strategies to engage schools from the outset, tailored to regional and national settings.