School districts are increasingly initiating random drug-testing (RDT) programs in an effort to curb substance-use rates among students, yet little is known about student attitudes toward RDT and potential obstacles to program acceptance and effectiveness. The authors surveyed 1011 9th through 11th grade students in 2 rural high schools in North Florida regarding the pending implementation of one of the most aggressive RDT programs in the nation. A significant majority of students predicted that RDT would be effective, yet students were more clearly divided in their perceptions of the fairness and the accuracy of testing. Student perceptions of whether there is a drug problem at their school proved to be a robust predictor of perceptions of policy fairness. Student substance-use rates were more limited predictors of policy effectiveness and fairness. These results may prove useful to school administrators, health professionals, and policy makers seeking to build acceptance for RDT in their schools.