The continuum of educational environments exists to ensure the most appropriate and least restrictive educational setting for students with disabilities. One setting schools use to provide services to students with an emotional disturbance (ED) is an alternative school. How schools make decisions regarding student placement into and out of this setting lacks examination. This study identifies factors considered when making placements into and out of three alternative schools for students with ED. A mixed-methods approach was used to collect data from key stakeholders from each school involved with decision-making authority regarding student placement. Findings include (a) limited transitioning of students back to less restrictive settings, (b) greater number of factors considered during exit decisions from alternative schools than entry, and (c) student’s return to a less restrictive setting not contingent on those factors considered when placing the student into the school.