Only mentioning the words “head lice” will result in anxiety and itching among parents, school nurses, and health care providers. There are approximately 6–12 million cases of head lice infestations per year in the United States (Center for Disease Control and Prevention, Parasites: lice: head lice. https://www.cdc.gov/parasites/lice/head/index.html . Accessed 13 Feb 2024) and though head lice are not known to transmit disease or cause serious health problems, cases of head lice account for billions of dollars of healthcare costs and parental lost wages annually (Mumcuoglu et al., Int J Dermatol. 45:891–896, 2006). Based on recent evidence and research, guidance for schools on screening, treatment, and general policies regarding head lice have been updated. In this chapter, we will review this evidence and guidelines.