As emergencies continue to impact communities in the United States on an unprecedented scale, it is imperative for communities to look for effective ways to keep people safe and reduce future impacts. Public alert and warning systems are an effective means of accomplishing these goals. As such, researchers have studied public alert and warning systems extensively in the United States. Due to the plethora of studies on public alert and warning systems, a systematic and comprehensive synthesize is needed to understand what has been studied and their major findings and identify practical lessons that can be used to further improve public alert and warning systems. Hence, the goal of this study is to answer the following two questions: (1) What are the major findings from public alert and warning system research? (2) What policy and practical lessons can be gleaned from public alert and warning system research to improve public alert and warning system research and practice? We answer these questions by conducting a systematic and comprehensive review of the public alert and warning system literature, starting with a keyword search. The search produced 1,737 studies, and we applied six criteria (e.g., the study has to be a peer-reviewed article, dissertation, or conference paper), which narrowed the number of studies to 100. After analyzing the 100 studies, the results reveal 12 emergent themes regarding the major findings from public alert and warning system research. The results also reveal eight emergent themes related to the policy and practical lessons. We then offer recommended topics for future research as well as outline some policy and practical recommendations. We conclude by summarizing the findings and discussing the limitations of the study.