The present study builds on the earlier work of Thurlow et al. (1995) and Guy et al. (1999). These earlier studies examined state graduation policies and diploma options across all 50 states and the District of Columbia. The purposes of these earlier studies were to: (1) provide policy makers and state education agency personnel information on the current cross-state status of graduation requirements, and (2) create a database to track changes in policy as states proceed to develop and change graduation policies. This study was undertaken to update the status of states' graduation policies. Three primary questions served as the focus of this national study of high school graduation requirements and diploma options for students with and without disabilities. These questions were: (1) What is the range and variation in state graduation requirements and diploma options across the United States for students with and without disabilities?; (2) What are the intended and unintended consequences that result for students with disabilities when they are required to pass exit exams to receive a high school diploma?; and (3) What are the intended and unintended consequences of using single or multiple diploma options for students with disabilities? Respondents included the state directors of special education or their designees in all 50 states and the District of Columbia. As illustrated within this study, as well as those cited in this report, the range and variation in state graduation requirements for students with and without disabilities is extensive. Changes in graduation policies and requirements are also occurring frequently across states. Further, many states have opted to create an array of alternative or differentiated diplomas in response to a variety of needs and pressures. The meaning and value of all of these graduation requirements are, however, not well understood. "High-stakes" testing also continues to increase as an accountability strategy to ensure that students graduate with a diploma that acknowledges what they have learned. These trends in state policies and practices are all moving forward without careful study or examination of their consequences for students, families, professionals, or school systems. Offered in this paper are several recommendations that may help to guide state and local district decision-making when adopting state graduation requirements and alternative diploma options. (Contains 11 tables.)