During 2012, Massachusetts adopted comprehensive school competitive food and beverage standards that closely align with Institute of Medicine recommendations and Smart Snacks in School national standards. The NOURISH study examined middle and high schools’ compliance with the Massachusetts standards after the first year of implementation. Employing an observational cohort study with a pre-/post-test design, researchers collected data via school site visits and a food service director questionnaire. Multilevel models were used to examine change in food and beverage compliance over time. At both time points, more products were available in high schools than middle schools. The number of products sold across all product categories decreased between 2012 and 2013 at both school levels. Compliant foods sold in middle and high schools had significant increases from 13 percent to 69 percent and 54 percent, respectively, whereas compliant beverages sold in middle schools increased from 46 percent to 87 percent and from 28 percent to 80 percent in high schools.