Turning around low-performing schools is hard. Strategies financed by federal dollars have shown disappointing results, and states have avoided fundamental reforms even as they hired specialists and retrained school staff. State leaders can adopt or adapt three approaches already in use if they want to go beyond cosmetic remedies for troubled schools. The first is charter expansion, wherein schools identified for comprehensive or targeted support are replaced by or converted into charter schools. Second are state turnaround districts, in which the state withdraws control of struggling schools from their home districts and creates a state-managed entity that assumes responsibility for getting those schools to an acceptable level of performance over some period. Third are state-led but district-based solutions, where a state-appointed individual or entity essentially assumes plenary power over a district (or subdistrict) and decides what solutions fit each individual school. These three options are presented in this article.