With the steady increase in the English Language Learner (ELL) population in the U.S., this case study was aimed at capturing elementary teachers' perceptions of how well their teacher preparation program was prepared to teach ELLs. This work utilized the case study design, and included five North American elementary teachers as the subjects of the research who were teaching ELLs in a small Christian Academy located in southern Haiti. All of the teachers were fluent in English, and two of the teachers from Canada were also fluent in French. All of the elementary students spoke Creole. The instruments in the case study included a questionnaire, two interviews, and classroom observations of teaching. The data was coded and triangulated. The results of this study supported existing research, and specifically included a desire for explicit coursework on how to teach reading to ELLs within their teacher preparation program, as well as increased time instructing ELL students in high ELL population schools that utilized inclusive instruction during their student teaching placements. Required second language coursework was also recommended, as the teachers believed it would have enhanced their understanding of the complexity of language acquisition and develop empathy for ELL students.