This paper explores school refusal, a behavioral condition marked by a child's reluctance or avoidance of school attendance, often presenting with physical, emotional, or behavioral symptoms. Although not a formal mental health diagnosis, it is a significant concern affecting an estimated 1–5% of children, particularly those aged 5–10 years. School refusal carries substantial short-term risks like academic decline and long-term consequences such as school dropout, social difficulties, and psychiatric disorders. The sources highlight that school refusal is significantly more prevalent, has an earlier onset, and is more prolonged in autistic children compared to their typically developing peers. Complex factors contribute to this phenomenon in autistic students, including profound difficulties with social functioning and heightened vulnerability to bullying, with victimization rates reaching 46–94%. Other contributing factors include challenges during school transitions (e.g., elementary to high school), sensory sensitivities, and the high comorbidity of psychiatric conditions such as anxiety and depression. The paper emphasizes the critical need for vigilance, early identification, and comprehensive interventions, including managing anxiety, promoting social skills, and preventing bullying, to support autistic students and ensure their educational and socio-emotional well-being.