The Middle School Concept brings together good teaching practices with the unique needs of pre-adolescent students. Since the passing of the NCLB, more and more attention has been generated on the results of high stakes testing. The question of what happens to the middle school concept when it confronts the demands of this new age of testing is critical in understanding how to meet the multiple needs of the students and the school's need for accountability. This qualitative study follows a previous quantitative study conducted to determine the state of the middle school concept in Tennessee. The school with the highest interest in and implementation of the middle school concept was visited by the authors. They found that despite the pressure from escalating accountability and standardization efforts by the state and federal governments, the principal and staff at this school still believe that the middle school concept best meets the educational needs of young adolescents.