This study assessed the medication administration practices of school nurses. From a random sample of 1,000 members of the National Association of School Nurses, 649 (64.9%) completed the survey developed for the study. These school nurses report that during a typical day, 5.6% of children receive medication in school, with 3.3% receiving medications for ADHD. Almost all the school nurses follow written guidelines for administering medication. Potential problems were identified in documenting side effects of medications, storage of medications, student self-administration practices, and appropriate authorization of nonprescription drug use. Most nurses (75.6%) delegate medication administration to unlicensed assistive personnel (UAP), with secretaries (66.2%) the most common UAP. Discomfort with delegation and confusion over state nurse practice laws were noted. Errors in administering medications were reported by 48.5% of the school nurses, with missed dose (79.7%) the most common error. Factors identified as contributing to errors included use of UAP and responsibility for large numbers of students.