Even though there are books that guide students in preparing for TOEFL exams, the literature on TOEFL test preparation courses at the university level is sparse (Huang, 2018). The current study aimed to fill the research gap by investigating the impact of TOEFL ITP assessment on teachers' TOEFL course content and teaching methods. Five different TOEFL classes and four TOEFL instructors participated in the study. Following a qualitative research design (Glesne, 2015), fourteen classroom observations, fourteen student interviews, and four teacher interviews were collected. A combination of the Communicative Orientation of Language Teaching (COLT) observation scheme (Spada & Frohlich, 1995) and Miles & Huberman's (1994) inductive approach were used to analyze classroom observations. The results from the observations were triangulated with student and teacher interviews. Findings indicated that teachers relied on the TOEFL textbooks to teach and practice test-taking strategies. They followed a "teach-model-practice-explain" structure during their instruction and spent the majority of class time conducting teacher-centered activity and student-alone activity. Additionally, teachers' beliefs shaped their teaching methods, and their different beliefs led to students' varied attitudes toward the TOEFL class. Pedagogical implications of implementing TOEFL classes at English language programs were discussed.