Although it may not be possible to fully understand how state-based accountability (SBA) initiatives influence mathematics teachers in-classroom approach to the subject matter, it is important to understand that instructional reform efforts that become externally mandated testing policies do affect teachers’ decisions about classroom content. While SBA systems do not mandate specific instructional approaches for teachers, any effects of SBA on student achievement are likely to occur largely because of changes in teachers’ approaches to their subject matter. SBA systems also change teachers’ classroom practices by creating stronger incentives to improve student testing achievement, which in turn may lead teachers to focus on raising test scores rather than improving student achievement more generally. Using a stratified random sampling procedure, this study selected 25 school districts from three states and randomly selected 100 schools per state from these districts to survey mathematics teachers’ responses to SBA. One-half of respondents expressed concern about high-achieving students-valuable information about the ways that SBA is influencing teachers’ classroom work. Any use of surveys for accountability purposes must include safeguards to limit bias. By presenting a framework for understanding teacher responses to SBA testing requirements, this work sets the stage for a more formal investigation of these questions. To inform the debate about whether SBA leads to genuine improvement in student achievement or to inflated scores that indicate a too-narrow curriculum, SBA systems must be monitored for bias, political backlash, and high costs.