High stakes accountability (HSA) reforms were enacted in state after state and federally through the No Child Left Behind law, based on the belief that incentives that have consequences attached are effective ways to motivate educators to improve student performance. Our focus for this article is on school district level responses to HSA reforms that could produce positive changes in teaching and learning. We set out to determine whether a district effect was present in the implementation of HSA systems in six southern states and whether that effect was accompanied by the types of activities previously identified in the research literature as being associated with changes in teaching and learning and student achievement. We tested a theory of action that assumed that HSA would cause school districts to develop coherent instructional strategies that would be evidenced by the provision of coherent, high-quality professional development and the alignment of district policy and resources in support of school improvement. These activities on the part of districts would then improve student achievement as measured by state tests. (Contains 9 tables and 2 notes.)