Rural food pantries aim to improve food access but low-quality nutritional environments and prescribed systems of food distribution may limit these efforts. Voices for Food (VFF) is a six-state U.S. Department of Agriculture-funded intervention, including community coaching and a VFF Food Pantry Toolkit to guide food pantries in transitioning to a healthier nutritional environment and a food distribution system based on client choice and support.The purpose of the article was to create a novel tool (MyChoice Scorecard) to assess the food pantry environment, including client choice, and to use the tool to quantify change in VFF intervention pantries compared with comparison pantries longitudinally over the 3-year study period. Food pantries in rural, high-poverty counties in six Midwestern states participated in a longitudinal, matched treatment and comparison study. Pantries were assigned to treatment (n = 12) or comparison (n = 12) group. A MyChoice Scorecard was completed pre-, mid- and post-intervention. Mixed models were generated with MyChoice Scorecard score as the outcome and included main effects for intervention group and time since pre-intervention visit. Pre-intervention, MyChoice scores did not differ significantly between intervention and comparison pantries (8.5 ± 1.5 vs. 9.1 ± 1.5, p = .19). Marginal mean values for MyChoice Scorecard score differed significantly between treatment and comparison groups at both mid-intervention (14.6 ± 1.4 vs. 10.8 ± 1.4, p = .05) and post-intervention (21.8 ± 1.2 vs. 11.8 ± 1.2, p < .001). The MyChoice Scorecard, either alone or as part of the VFF intervention, can be used by community public health professionals, such as Extension staff, to document and facilitate meaningful change in the nutritional environment of food pantries.