Background: School nutrition reform continues to be of interest to many due to the potential for widespread benefits for students who eat at school. however, disparities still exist in implementing the mandates resulting from the 2010 Healthy, Hunger-Free Kids Act. Purpose: The purpose of this study was to investigate middle school stakeholders' perspectives on the school food environment since the initiation of school nutrition reform. Methods: Stakeholders from 14 public middle schools participated in interviews on topics related to school nutrition reform. Results: Major themes included benefits, barriers and recommendations to improve the food environment. reciprocal determinism provided a framework for understanding the interactions of behavior, the environment and personal factors affecting the implementation of school nutrition reform. Discussion: Key informants felt that if schools had more flexibility and decision-making power in what school nutrition reform looked like for their particular community, the program would be more successful. Translation to Health Education Practice: Insights from this investigation emphasize the interaction of the home and school environment, on personal and behavioral factors of students. for reform to be successful, schools must involve stakeholders, use local resources, and conduct periodic needs assessment to determine the appropriate strategies to improve the school food environment. [This is the online version of an article published in "American Journal of Health Education." For the final published version of this article, see?EJ1310660.]