High-stakes testing has increased since the passage of the federal No Child Left Behind Act (NCLB) of 2001. Many teachers are using teacher-centered activities with memorization and testing coach books instead of creating student-centered higher-order thinking activities. Some school districts are eliminating subjects that are not tested on state assessments. The purpose of this study was to collect information regarding the teaching experiences of 9 elementary teachers from the same school within one public school district. Teacher interviews were utilized in this case study to explore the perceived effects of high-stakes tests on elementary curriculum and instruction. The theoretical foundation for this study was based on the theories of behaviorism and constructivism. The study research questions addressed teachers' perceptions of the effects of high-stakes testing on curriculum and instruction. Qualitative coding was used to identify patterns and themes in the data through the systematic analysis and constant comparison of data sets. Data from interview transcripts were analyzed to determine factors, events, conditions, personal perspectives, and concerns of the elementary teachers. Teachers felt that high-stakes testing has resulted in a rigid, unbalanced and narrow curriculum. Teachers described that high-stakes testing has resulted in clear expectations for teachers which have helped them to know exactly what they have to teach within their classrooms. Implications for positive social change include providing teachers with necessary professional development relating to the effects of high-stakes testing; this can lead to curricular and instructional change that provides more instruction in higher-order thinking. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]