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School refusal behavior can lead to disruptions in both educational attainment and social development. One of the common causes of school refusal behavior is separation anxiety disorder (SAD). Research suggests that children with SAD and school refusal behavior show an increased rate of psychiatric consultation and a decreased likelihood of becoming parents in adulthood, likely indicating limited social skills (Flakierska-Praquin, Lindstrom, & Gillberg, 1997). This article provides a brief overview of the current literature on the association between SAD and school refusal behavior, as well as a proposed treatment for school refusal behavior associated with SAD based on cognitive-behavioral theory.