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Promoting Alternative Thinking Strategies (PATHS) is a widely-used social emotional learning program for preschool and elementary school students. The purpose of the current review is to examine its effects, and explore the moderation effects of methodological and implementation features. Using stringent inclusion criteria, 20 qualified studies involving 30,454 participants were included. The PATHS effect on social emotional skills (ES=0.16) was the largest compared with other outcome domains, including attitude or relations (ES=0.08), emotional well-being (ES=0.02), prosocial behaviors (ES=0.04), conduct problems (ES=0.06) and academic performance (ES=0.05). There was no differential impact of PATHS on regular students and targeted students. Research design, sample size, and intervention dosage could moderate the PATHS effectiveness significantly, and dosage was the predominant factor.