This article examines the decisions made by one principal in her first year as a school turnaround specialist in a low-performing urban elementary school. Researchers focused on decisions related to the principal's three high-priority concerns: (1) elimination of an ineffective instructional program; (2) creation of a culture of teacher accountability; and (3) development of an effective reading program. Forty-nine decisions were identified and organized into five categories--performance, policy, program, process, and personnel decisions. The study concludes with a discussion of what principals need to know in order to make the kinds of decisions required of a "turnaround" principal. (Contains 2 tables and 2 figures.)