Many studies have been conducted and literature produced surrounding the effects of No Child Left Behind (NCLB). This study examines the effects of NCLB and its impact on four rural southeastern Ohio school districts. Each district, classified as in need of improvement by the Ohio Department of Education, participated in the Ohio Improvement Process in an attempt to improve student achievement and meet the mandates of NCLB. The purpose of this study was to answer why school districts in rural southeast Ohio who have implemented the Ohio Improvement Process have various results on State assessments. A qualitative case study was conducted utilizing face-to-face interviews, examination of district report cards, collective bargaining agreements, district finances, and cultural influences. The method employed by the researcher to compile and filter the data gathered as a result of the interviews was hand-coding. Additional color-coding were used for commonality of terms. Overall, three themes, each with several sub-themes, emerged from the interview process.