Priority health risk behaviors (i.e. preventable behaviors that contribute to the leading causes of morbidity and mortality) are often established during childhood and adolescence and extend into adulthood. Ongoing surveillance of youth risk behaviors is critical for the design, implementation, and evaluation of public health interventions to improve adolescent health. The Youth Risk Behavior Survey (YRBS) is a national surveillance system that was established in 1991 by the Centers for Disease Control and Prevention (CDC) to monitor the prevalence of health risk behaviors among youth. YRBS data are routinely collected on high school students, but only a few states collect data in middle schools. The Nevada Middle School YRBS is biennial, anonymous and voluntary survey of students in 6th through 8th grade in regular public, charter, and alternative schools. Students self-report their behaviors in five major areas of health that directly lead to morbidity and mortality, these include: 1) Behaviors that contribute to unintentional injuries and violence; 2) Tobacco use; 3) Alcohol and other drug use; 4) Unhealthy dietary behaviors; and 5) Physical inactivity. The Nevada Middle School YRBS provides prevalence estimates for priority risk behaviors and can be used to monitor trends over time.