Although the successful middle level school was designed to address both the affective and cognitive development of young adolescents (NMSA 2003), academic achievement is the outcome of paramount importance in the current political context of accountability, high-stakes testing, and the No Child Left Behind Act of 2001. In their efforts to reform, many middle level schools have implemented programmatic components like the teaming of teachers, advisory periods, and exploratory curricula. Few have truly explored the relationship between these structural changes and a school's organizational health. This mixed-methods study focuses on three dimensions of organizational health (teacher affiliation, resource support, and academic emphasis) and their relationship to academic performance. Findings indicate a positive relationship between a school's academic emphasis and students' academic performance. In an effort to more fully explore this finding, qualitative data are presented.