The nitroxide-mediated controlled radical polymerization (NM-CRP) of 4-acetoxystyrene with an alkoxyamine was analyzed by a combined experimental and modeling approach. At low nitroxide concentrations, thermal initiation was significant, and control of the polydispersity was poor, as was observed previously for styrene. A continuum model based on the method of moments was used to regress the parameters for the reversible nitroxide uncoupling/coupling reactions (activation energy of uncoupling), thermal initiation (activation energy of initiation), and termination (frequency factor of recombination). The model was able to capture the molecular weight averages and the polydispersity index as a function of time and the nitroxide concentration qualitatively and quantitatively. Using this mechanistic framework, we developed kinetic Monte Carlo models that allowed the molecular weight distributions to be predicted explicitly in good agreement with experimental data. A comparison of the NM-CRP of 4-acetoxystyrene and styrene is provided to illustrate the effect of the acetoxy substituent.