Sexual violence is a worldwide issue that impacts many individuals, often with serious and long-lasting effects. Students represent a high-risk group for sexual violence on campuses. As a result, various government initiatives have called for Universities and Colleges to develop policies and sexual violence prevention initiatives. However, much of the focus has been on the effect of the initiatives with less attention to students’ experiences. Thus, the purpose of this qualitative systematic review with meta-synthesis was to critically appraise and synthesize the evidence (e.g., themes) regarding students’ experiences with campus sexual assault prevention initiatives. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis and Joanna Briggs Institute guidelines were followed. Six databases were systematically searched, which yielded 2,090 papers. This resulted in 21 published papers meeting the inclusion criteria of a primary, English language, qualitative or mixed-methods study exploring students’ experiences of campus sexual assault initiatives. Two researchers independently extracted data and completed quality appraisals. The meta-synthesis identified four synthesized findings: (1) dichotomous perceptions of sexual violence initiatives, (2) the need for enhanced awareness, (3) modality matters, and (4) intended and unintended outcomes. Overall, these findings suggest that students valued the attention to the issue of sexual violence; however, they identified concerns that warrant attention. This has important implications for program and policy development as having programs that meet students’ needs may result in enhanced student engagement which may, in turn, lead to increased efficacy. Moreover, initiatives that may result in harm to survivors require careful consideration.