A 27-year longitudinal study of 60 young adults of IQ 160+ has found that while a minority were assisted to fulfill their remarkable potential, severe, ongoing academic underachievement was imposed on others by schools unwilling to make special provisions. Examine the academic and socio-emotional outcomes of various forms of acceleration and grouping, compared with retention in the mainstream classroom, and discuss the young people’s feelings about achievement and underachievement, self-esteem, friendship and love relationships, career choice, family support, and what they believe to be optimal educational environments for highly gifted children and adolescents.