This article presents findings from a study of five head teachers who were responsible for the management of serious teacher misbehaviour (TMB) in England. In cases that included the downloading of extreme pornography on a school laptop and a sexual relationship with a pupil, the multiple impacts of TMB were potentially devastating to the well-being of pupils, staff and the reputation of the schools. The article highlights a number of strategies for managing serious TMB considered best practice by the head teachers as well as discussing other, more nuanced issues that accompany such cases including trust relations, the influence of gender and the difficulty of simultaneous immersion and detachment required of head teachers to effectively manage such cases.