The National School Lunch Program (NSLP) is a federal program that provides free and reduced priced lunch to millions of low-income children in urban schools. Empirical research shows mixed results on the physical and nutritional health of urban students participating in the program. However, a considerable limitation of this literature is that it focuses on student participation in the NSLP rather than what students consume when they receive a school lunch. By directly collecting a random of sample of school lunches, we analyze the nutritional content of both selected and consumed school lunches (n = 141) at a Title I middle school in a large US city. Results indicated that the food items that students select for school lunch are low in nutrients and high in sugar. Furthermore, food that students ultimately consumed during lunch had even lower nutritional value while consumption of sugar remained high. Future research is needed to investigate school-based interventions that leaders can deploy to foster healthy eating in urban schools.