Purpose/Objectives: The purpose of this research was to determine the prevalence of special food and/or nutrition needs in school nutrition programs. In addition, researchers focused on the issues surrounding these needs and the role of the school nutrition (SN) directors and managers in meeting these needs. Methods: An expert panel was used to help develop a questionnaire to address special food and/or nutrition needs in a school setting. Based on the feedback, a survey was developed and sent to 700 SN directors and 700 SN managers throughout the seven USDA regions. Results: A total of 405 surveys (28.9%) were used in the final analysis. Milk allergies were the most frequently reported special need (80.6%). Participants most strongly agreed that a physician's order must be received before a special needs diet can be provided and the specific requirements of the diet need to be outlined. SN directors were responsible for planning the diets, yet the SN staff was responsible for preparing the meals. Approximately one-half of the SN directors and managers reported being responsible for purchasing the items to accommodate the special dietary needs. Applications to Child Nutrition Professionals: As the prevalence of special needs continues to rise, SN professionals must be prepared to accommodate these needs. There are several issues and challenges when meeting special food/or and nutrition needs. Both SN directors and managers should be prepared for the issues they will face and take ownership of their roles in meeting these needs. (Contains 4 tables.)