Although the federal No Child Left Behind program judges the effectiveness of schools based on their students' achievement status, many policy analysts argue that schools should be measured, instead, by their students' achievement growth. Using a 10-year student-level panel data set from North Carolina, we examine how school-specific pressure associated with status and growth approaches to school accountability affect student achievement at different points in the prior-year achievement distribution. Achievement gains for students below the proficiency cut point emerge in schools failing either type of accountability standard, with the effects clearer for math than for reading. In contrast to prior research highlighting the possibility of educational triage, we find little or no evidence that failing schools in North Carolina ignore the students far below proficiency under either approach. Importantly, we find that the status, but not the growth, approach reduces the reading achievement of higher performing students. Our analysis suggests that the distributional effects of accountability pressure depend not only on the type of pressure for which schools are held accountable (status or growth), but also the tested subject. © 2010 by the Association for Public Policy Analysis and Management.