This paper seeks to improve our understanding of the challenges faced by teachers and student-teachers in the process of implementing small group work (SGW) in early childhood education (ECE). In light of the discrepancy between the clear benefits of SGW in education--its solid theoretical foundation--and its sparse and poor implementation, we posed the following research questions: (a) What are Israeli teachers' perceptions of and attitudes toward small group work and its implementation in ECE? And (b) What do teachers see as problematic or, conversely, helpful in overcoming difficulties related to its implementation in ECE? Both qualitative and quantitative methods were employed: a questionnaire with closed and open-ended questions to measure the attitudes and perceptions of thirty experienced teachers, as well as action research documenting the implementation of SGW in two cases. Findings showed more positive attitudes toward SGW than toward the feasibility of its implementation, which was frequently associated with drilling skills, rather than discourse that supports the construction of knowledge. Difficulties in implementing SGW included a lack of coordinated staff work and the absence of routines and planning of space and time. The action research indicated that the effective implementation of SGW necessitates planning, observation, and documentation of both the interactions in groups as well as classroom management aspects related to its implementation, and that it requires a commitment to the children's well-being and learning.