This report examines the impact of the No Child Left Behind Act (NCLB) on student achievement and teacher quality in rural school districts and the challenges those rural districts face in complying with the Act. It also analyzes differences in responses to NCLB between rural districts and urban or suburban districts. Findings are drawn from the 2006-07 Center on Education Policy (CEP) survey of NCLB implementation in 349 responding school districts, and from interviews with administrators in eight rural districts in various parts of the country. Reported findings include: (1) Rural districts, like urban and suburban districts, rated their own district policies and programs as more important causes of improved student achievement than they rated the provisions of NCLB except for Reading First programs and school improvement plans; (2) Reading First programs and school improvement plans are considered as important or very important contributors to improvements in student achievement by the majority of participating rural districts; (3) In response to NCLB, rural case study districts have better aligned their curriculum with test content and have sharpened their focus on individualized instruction; (4) Sizable percentages of rural districts surveyed have achievement gaps for students with disabilities and low-income students; (5) Fewer rural districts than urban or suburban districts report having achievement gaps for racial/ethnic minority students or English language learners (ELLs), but this is because they enroll too few of these students to calculate gaps under NCLB; (6) NCLB highly qualified teacher requirements have had a limited impact on teacher recruitment and retention in most rural districts; (7) Interviews with officials in case study districts indicate that they use recruitment and retention strategies shaped by their geographical and social environments; and (8) Rural districts report having the most difficulty complying fully with the high qualified teacher requirements for secondary school science and math teachers. The report concludes that although the special characteristics of small school size and geographical isolation create a range of challenges for rural districts in meeting NCLB requirements, impacting school performance at both student and teacher levels rural districts also face difficulties similar to those facing their non-rural counterparts, such as delays in receiving test scores, lack of guidance about using data for curricular and instructional improvement, and the need for improved accountability measures for students receiving special education services. (Contains 5 footnotes and 9 tables.)