Background: The study objective was to determine impact of a Farm-to-School intervention on low-income, diverse elementary school students' nutrition-related attitudes, self-efficacy, behaviors, and locally grown vegetable choices. Methods: Six elementary schools within 1 US school district were equally assigned to 1 of 3 conditions--Local Message, Nutrition Message, or Control. Locally grown vegetables (kale, green beans, zucchini, butternut squash, and beets) were served twice during lunch over 16 weeks. "Local" and "Nutrition" groups also received biweekly nutrition education and a messaging campaign in the cafeteria. Knowledge, attitudes, self-efficacy, and related behaviors were assessed using a validated questionnaire. Vegetable selection was assessed using the food service daily production records. General linear model analysis, analysis of covariance, and t tests were performed. Results: Students in the "Local" group (N = 81) had significantly improved nutrition-related attitudes (p = 0.0001), preferences (p = 0.001), and overall vegetable behavior score (p = 0.002), compared to control (N = 79). There was no difference in overall locally grown vegetable choices, but local beet choices were higher in the "Local" (p = 0.005) and "Nutrition" (p = 0.02) groups compared to control. Conclusions: Messages about local foods in school cafeterias may improve students' attitudes, preferences, and selection of certain locally grown vegetables.