Background: District size has been shown to impact the anticipated barriers to wellness policy creation and implementation. Therefore, the purpose of the present study was to determine if strength and comprehensiveness of wellness policies differs among school districts of varying size. Methods: Wellness policies were collected from 10 large, 29 medium, and 31 small school districts in a rural Midwest state. District size was categorized by the average daily membership in grades 9-11. Polices were coded using the Wellness School Assessment Tool (WellSAT). Strength and comprehensiveness of the full policy and policy sections were compared among small, medium, and large districts using 1-way analyses of variance (ANOVAs). Data are presented as mean ± SD. Statistical significance was set at p = 0.05. Results: There was a difference in the total combined (p = 0.041), total comprehensiveness (p = 0.043), and total strength scores (p = 0.031) based on school district size, such that small districts had stronger, more comprehensive wellness policies than large districts. Section comparisons revealed the section focused on Standards for United States Department of Agriculture School Meals was primarily responsible for these differences. Conclusions: These data suggest smaller districts write policies that are more comprehensive to governmental standards and use more definitive language than larger districts.