Since its establishment in 1996, the North Carolina Early Mathematics Placement Testing (NC EMPT) Program has provided a low stakes reality check of readiness for college-level mathematics to more than 600,000 high school students statewide. The program strives to help reduce the percentage of incoming college freshmen requiring mathematics remediation. The current study involved matched high school and college level data on n=3564 students who attended high school in NC, completed the NC EMPT between 2001-2004, and subsequently enrolled at East Carolina University. Student performance on NC EMPT is matched with later college-level mathematics course information and six-year graduation rates. Students who failed the NC EMPT enrolled in remedial courses at significantly higher rates (42% versus 11% among those that pass the NC EMPT) and were significantly more likely to fail both remedial algebra and college algebra. While there are no significant differences in the six-year graduation rates between those who do and do not pass the NC EMPT, those that passed did finish with significantly higher mean GPAs (3.06 versus 2.91, p < 0.0001). Results indicate that the NC EMPT is a useful and powerful early warning tool in assessing the readiness of high school students for college algebra.