This study was conducted to determine the effectiveness of alternative middle school programs utilizing a longitudinal, mixed methods design and was driven by research questions which analyzed trends in attendance, discipline, and Standard of Learning test pass rates in history and science for 8th, 9th, and 10th grade. It also examined student perceptions concerning preparedness for high school, skills previously taught, transition to high school, and relationships with peers and adults. Data on attendance, discipline, and SOL scores were collected from 34 students from the 2009-2010 8th grade cohort who attended one of two alternative middle schools. Attendance data indicated a decrease in the number of absences each year from 8th – 10th grade, ranging from two days to 53 days per student. Discipline data reflected a drop in discipline referrals, each year, from 8th to 10th grade. The greatest improvement in discipline, indicated by a decrease in per student referrals, occurred between 9th and 10th grade. History SOL results indicated a pass rate that remained between 70% - 71% for grades 8-10. The test results for the science SOL showed a drop in number of students passing from 8th to 9th grade and increasing from 9th to 10th grade. An analysis of interviews with twelve students found that they perceived their alternative middle experience as having a positive effect on relationships, both with peers and adults, and a desire to graduate. They attributed an improvement in relationship skills and ability to select positive relationships with alternative middle school attendance. Students consistently noted small class size, as experienced in the alternative middle school, as an influence on both behavior and achievement. Students previously considering dropping out of school felt their alternative middle school experience had contributed to their changed mindsets and goals. Overall this study indicated that students attending the alternative middle school for 8th grade perceived their experiences as providing greater social rather than academic preparation for high school. In addition, best practices are similar for high school and middle school alternative programs.