A survey of the literature on evolution instruction provides evidence that teachers' personal views and understandings can shape instructional approaches and content delivered in science classrooms regardless of established science standards. This study is the first to quantify evolutionary worldviews of in-service teachers in the Caribbean, specifically in Belize, an English-speaking nation with a high school system guided by a regional biology syllabus and strict standardized tests. Using the Measure of Acceptance of the Theory of Evolution (MATE) instrument and knowledge test, we investigated (1) the current level of acceptance and understanding of evolution as given by 97% of high school biology teachers in Belize; (2) the factors associated with acceptance and understanding of evolutionary theory. With an average MATE score of 64.4 and a mean knowledge score of 47.9%, Belizean teachers were classified as having both "Low Acceptance" and "Low Understanding" of evolutionary theory. A positive correlation was found between teacher acceptance and understanding of evolution. A review of the Caribbean Secondary Examination Certificate biology syllabus suggests that evolution plays a minimal role in the high school biology classroom. We believe that Belize presents a unique opening for future training on evolution instruction since 57% of the biology teachers self-proclaim to be unprepared to teach evolution. The results of this study have implications for policy, practice and research with teachers' acceptance, understanding and confidence in teaching evolution serving as important predictors for instructional approaches used in the biology classroom. (Contains 4 tables and 5 figures.)