The purpose of this longitudinal case study was to develop a process and structure for adopting and leading critical school reform initiatives within a rural North Dakota pre-kindergarten through fourth grade elementary school. Elementary principals can use this process and structure to benefit staff, and ultimately, to improve student academic achievement. This longitudinal case study identified factors that facilitated or hindered a rural practicing elementary principal, staff, and school while implementing federal, state, and local school reform initiatives beginning in the 2005-2006 school year. This longitudinal case study utilized a qualitative, grounded theory and case study approach to identify: (a) What factors facilitated or hindered the development of a process and structure for adopting and leading critical school reform initiatives, (b) What role key stakeholders played in the development of a process and structure for adopting and leading critical school reform initiatives, and (c) What effects the development of a process and structure for adopting and leading critical school reform initiatives had on student achievement. For the purpose of this longitudinal case study, key stakeholders included: a school district superintendent, elementary principal, elementary classroom teachers and staff, school specialists, and members of school district committees. School district data included: public documents, committee meeting and survey results, observations, field notes, along with information obtained from the North Dakota Department of Public Instruction's website relating to Century Elementary School for school years ranging from 2005 through 2011. Results from this longitudinal case study explain implementation of school reform is complicated because many uncontrollable variables infiltrate the daily work of school leaders. The complication of school reform detracts their attention from the work that is important. The study results reflected seven school years of events summarized for the purpose of explaining school reform implementation over time for continuous improvement and development which took place in increments and stages. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]