Background: Key findings from the literature on treatment interventions with youth with Autism Spectrum Disorder (ASD) indicate that the most successful approaches allow frequent opportunities for uncontrived social interactions and are customizable to the needs of individuals and the group. Adventure therapy meets these criteria while providing opportunities for processing here-and-now behaviors in relation to life beyond school. Purpose: The purpose of this article is to present one model of a peer-mediated adventure therapy program with high school students with ASD. Methodology/Approach: A case example is presented to highlight one student’s experience in the program over 3 years. The Social Skills Improvement System was administered on an annual basis for this student, and scores were analyzed to assess progress. Findings/Conclusions: Preliminary data for one student over 3 years indicate an overall increase in social skills and overall decrease in problem behaviors. The case example illuminates the rationale for using adventure therapy with youth ASD due to opportunities for uncontrived interaction, a group-driven process, and emphasis on the here-and-now. Implications: While the small evaluation and case example provided preliminary support for utilizing adventure in peer-mediated interventions with youth with ASD, further research is needed for more in-depth program evaluation and understanding.