This research examined existing reviews and meta-analyses of universal alcohol and drug prevention efforts to identify evidence for universal alcohol and illicit drug prevention strategies across different intervention settings. The authors found sufficient evidence to support universal prevention interventions for alcohol in family and school settings. In relation to reducing drug use, there was evidence for the use of school- and leisure-based universal primary prevention strategies. In contrast, evidence suggests that mass media campaigns are not effective in reducing drug use and more evidence is required to support prevention interventions in university, workplace, healthcare and community settings. This information can be used to guide alcohol and drug policy and the funding of prevention interventions.