An increasing body of research points to the significance of teacher-child relationships in shaping children's development. Extending the research literature on early childhood, this review examines the value of an attachment perspective to the study of teacher-child relationships in middle childhood. First, we discuss the conceptualization and assessment of teacher-child relationship quality from an attachment perspective. Second, we examine how attachment theory guides the search for antecedents at the child and teacher level. Third, we discuss some of the mechanisms that may explain the developmental significance of teacher-child relationships according to attachment theory. Finally, we discuss how attachment theory has inspired interventions to improve teacher-child relationship quality. We conclude that middle childhood has been understudied in attachment-based teacher-child relationship research and that insights from attachment theory and other perspectives need to be combined to progress our understanding of the role of teacher-child relationships in middle childhood.