The Centers for Disease Control and Prevention established School Health Profiles (Profiles) in 1996 to monitor school health policies and practices in secondary schools in states and school districts across the United States. Profiles is a system of surveys conducted biennially in even-numbered years and provides data on the following topics: health education requirements and content, physical education and activity, safe and supportive environments, health services, and school health coordination. In March 2020, the COVID-19 pandemic forced schools across the United States to close, interrupting Profiles administration. Data collection, originally planned for January-June, was extended in several states and local agencies through December 2020. The 2020 Profiles marks the first routine surveillance assessment of school health programs since the pandemic. Further, for the first time in system history, the 2020 Profiles report includes nationwide estimates in addition to state and district data. Profiles surveys are conducted by education and health agencies among middle and high school principals and lead health education teachers. This report describes Profiles methods, showcases results from the 2020 Profiles, summarizes changes over time, and reveals both strengths and weaknesses in school health programs nationwide. These data can be used to compare results across jurisdictions, plan and monitor programs, identify professional development needs, and support health-related policies and legislation.