Background: School Health Profiles (Profiles) results help states understand how they compare to each other on specific school health policies and practices. The purpose of this study was to develop composite measures of critical Profiles results and use them to rate each state on their overall performance. Methods: Using data from state Profiles surveys conducted in 2010, the authors examined 12 key practices: 6 related to a healthy school environment and 6 related to health education. States were divided into quartiles based on the percentage of schools in the state that engaged in the practice, and then rank-ordered based on the sum of their quartile scores. Results: Whereas some states have low ranks or high ranks in both sets of practices, others have a relatively low rank in one set but a high rank in the other. States with the lowest overall sums tend to be in the west and midwest, whereas states with the highest sums tend to be in the east. Conclusions: This study identifies states whose school health policies and practices should be emulated and other states whose policies and practices are in urgent need of improvement.