Research indicates that school nursing services are cost-effective, but the National Association of School Nurses estimates that 25% of schools do not have a school nurse (SN). The purpose of this study was to identify the characteristics of Illinois school districts that employed SNs. This was a secondary data analysis of Illinois School Report Card system data as well as data obtained from district websites regarding SNs. Employment of an SN was determined for 95% of the 862 existing districts. Binary logistic regression analysis found that district size was the largest significant predictor of employment of an SN. Other factors included the type of district and diversity of the teaching staff as well as the percentage of students receiving special education services or with limited English proficiency. These findings indicate where to focus advocacy and policy efforts to encourage employment of SNs.