Background: Diffusion of Innovations theory has been used to predict rates of adoption for a variety of programs. Purpose: The purpose of this study was to assess indicators that influence adoption of abstinence-only-until-marriage education as an innovation by middle school principals in Texas (N=433) as well as their likelihood of adopting such programs. Methods: This study utilized a paper survey that was mailed to principals. Results: Findings regarding characteristics of abstinence-only-until-marriage education: relative advantage, compatibility, complexity, trialability, and observability are analyzed and discussed. In addition, a series of multiple regression models to predict the likelihood of adoption are presented. Discussion: Findings indicated that middle school principals most willing to adopt abstinence-only-until-marriage education programs strongly believed that abstinence education provided important advantages, and perceived abstinence-only-until-marriage education to be consistent with his or her beliefs and values. Controlling for demographics, religious preferences and behavior, and the perceptions of the attributes of abstinence-only-until-marriage education, the principals' religious beliefs/practices, complexity and trialability remained significantly associated with the likelihood to adopt. Translation to Health Education Practice: Rates of adoption by school administrators should be considered when implementing a new health curriculum or health-related educational program, especially when it is a sensitive subject such as sexuality. (Contains 5 tables.)