Educational accountability systems that use test scores as the primary measure of performance are in use in many states. Research has shown that such high-stakes testing can have negative consequences, including narrowing of the curriculum and overemphasizing decontextualized skills. This study examined the impact of a particular form of high-stakes testing, dubbed milepost testing, in which tests are only given at selected grade levels. Data were gathered in Kentucky at a time when state-mandated tests were given in some subjects in grades 4, 7, and 11, and in other subjects in grades 5, 8, and 11. This approach was used to reduce the cost and the burden of assessment and accountability. The study found that many of the effects identified in previous research were present when tests were only given in selected grade levels. This study documents substantial differences in practice between tested and nontested grades and draws implications for national testing proposals that are currently being debated.