The current study explored the reasons that primary school teachers reported were tipping points for them in deciding whether or not and when to refer a child to the school student support team for excessive anxiety. Twenty teachers in two Queensland primary schools were interviewed. Content analysis of interview transcripts revealed six themes reflecting teachers' perceived reasons for deciding to refer anxious children: (1) impact on learning; (2) atypical child behaviour; (3) repeated difficulties that do not improve over time; (4) poor response to strategies; (5) teachers' need for support; and (6) information from parents/carers. Teachers considered different combinations of reasons and had many different tipping points for making a referral. Both teacher- and system-level influences impacted referral decisions. Implications and future research are discussed.