Background/Context: This study examines the extent of reform in preparation programs in school leadership in six states employing a comprehensive, whole-state intervention design. Although no studies of these or other comprehensive reform designs are available, there is a rich context surrounding preparation reform work that informed our investigation. First, there is an extensive body of literature that explores problems with the current content, culture, and structure of university-based preparation programs. Second, there is an abundant trove of research on the nature of effective leadership, findings to which reform work is pegged. Third, there are a few studies that track progress across programs on key aspects of reform (e.g., minority recruitment and selection). Finally, there are a handful of studies that have explored the scope and depth of preparation program reform in school administration over the last 15 years. Focus of the Study: This investigation explores the extent to which meaningful reform is occurring in university-based preparation programs in school leadership in response to significant calls for change, a growing body of information on the appropriate shape and texture of that change, and moderate to strong state (policy) demands for action. Setting: The study is based on efforts to rebuild preparation programs in 54 universities in six states, in the Midwest, mid-Atlantic region, Southwest, and Southeast. Intervention: Comprehensive state reforms were conducted in six states during 1993-2005. These interventions were designed to promote the development of high-quality leadership preparation programs against specific quality standards. The strategy is initiated by a state when it mandates that all institutions providing training for school administrators undergo simultaneously a formal process of external review against a body of standards and quality indicators set by the state. The strategy entails a period of program development; review of the proposed program by external experts according to public criteria consistent with the state policy mandates; face-to-face discussion between reviewers and programs sponsors; site visits, feedback, and revision as necessary; and state action based on the external review. The strategy is designed to measure each institution's best effort at creating a quality program, not simply the existing program. Accountability associated with whole-state review runs the continuum from "low stakes," where the feedback goes to the institutions to use as they see fit, to "high stakes," where the state uses the external reports to award or deny accreditation, effectively closing programs. Design/Collection/Analysis: In this qualitative study, we analyze original and secondary documents produced in response to a specific policy intervention in six states. Materials provided by the universities that describe and document their new leadership preparation programs--based on framing questions provided by the researchers--provide the bulk of the data. These materials are of two types: original materials prepared specifically for this study, and secondary source documents already developed for other purposes (e.g., faculty vitae, course syllabi). The principles and techniques of document analysis guided our understanding of the reports and the formation of our findings and recommendations. Findings: The article examines the following major findings: (1) most program developers are following an unproductive paradigm; (2) the results of reform are uneven and overall fall short of the mark; (3) lack of actionable theory is a major shortcoming; (4) reforms are hampered by weak curriculum focus and content; and (5) neglect of the technical and adaptive dimensions of change makes serious reform unlikely. Recommendations: Based on our findings and related scholarship on the reform of preparation programs, we present nine recommendations that, we believe, will lead to more productive work in developing high-quality initial certification programs for school leaders. Collectively, they provide a framework for (1) rebuilding work from an outcome-based paradigm; (2) creating a strong platform of actionable theory; (3) establishing a clear, coherent conceptual focus and foundation; (4) recruiting and selecting candidates through rigorous, value-based admissions; (5) developing and aligning the curriculum through a process of zero-based curriculum development; (6) grounding and integrating learning through practice-anchored learning experiences; (7) providing adequate support for technical and adaptive change; (8) replacing a culture of autonomy with a culture of community; and (9) maintaining quality and continual improvement through outcome-based accountability