The School Health Profiles (Profiles) is a system of surveys assessing school health policies and practices in states, large urban school districts, and territories. Profiles surveys are conducted biennially by education and health agencies among middle and high school principals and lead health education teachers. Profiles monitors the current status of the following indicators: (1) School health education requirements and content; (2) Physical education and physical activity; (3) Practices related to bullying and sexual harassment; (4) School health policies related to tobacco-use prevention and nutrition; (5) School-based health services; (6) Family engagement and community involvement; and (7) School health coordination. Education and health officials use Profiles data to (1) Describe school health policies and practices and compare them across jurisdictions; (2) Identify professional development needs; (3) Plan and monitor programs; (4) Support health-related policies and legislation; (5) Seek funding; and (6) Garner support for future surveys. This report provides statistical information regarding which indicators showed West Virginia middle and high schools ranking highest in the nation, and which indicators revealed West Virginia middle and high schools ranked lowest in the nation.