The movement toward universal pre-kindergarten (pre-K) presents policymakers and implementers with many new challenges. In their attempts to go to scale with high-quality early education programs, these leaders and decisionmakers find themselves with little guidance on how to proceed. In an initial effort to respond to the situation, this report looks at the challenges confronting states that are seeking to create statewide public systems of high-quality pre-K services, as well as some of the progress they have made in doing so. Drawing on a review of the literature and interviews with pre-K personnel in a representative sample of eight U.S. states, the report examines the policy choices and debates involved in implementing pre-K in an environment of fiscal uncertainty, focusing on the key issues of funding, auspice, access, accountability, and staffing. In addition, it looks at the unintended effects of particular universal pre-K policy choices on other child populations, families, and communities.