Accountability, autonomy, and choice play a leading role in recent school reforms in many countries. This report provides new evidence on whether students perform better in school systems that have such institutional measures in place. We implement an internationally comparative approach within a rigorous micro-econometric framework that accounts for the influences of a large set of student, family, school, and country characteristics. The student-level data used in the analysis comes from the PISA 2003 international student achievement test that encompasses up to 265,000 students from 37 countries. Our results reveal that different facets of accountability, autonomy, and choice are strongly associated with the level of student achievement across countries. With respect to accountability, students perform better where policies are in place that aim at students (external exit exams), teachers (monitoring of lessons), and schools (assessment-based comparisons). The combined achievement differences amount to more than one and a half PISA grade-level equivalents. Students in schools with hiring autonomy perform better on average, while they perform worse in schools with autonomy in formulating their budget. School autonomy over the budget, salaries, and course contents appears to be more beneficial when external exit exams hold schools accountable for their decisions.