Accountability has been a major feature of educational policy making across the globe, including in the US where there is a persistent focus on student achievement results. This paper examines how accountability influences organizational routines in US schools, paying particular attention to meeting routines. We draw upon in-depth qualitative data gathered in four urban middle schools in which approximately 40 math teachers were engaged in collaboration and data use in order to improve instruction. Over a period of 3 years, we conducted extensive observations of teacher team meetings and interviews with teachers and administrators. An analysis of data reveals that many meetings were dominated by organizational routines that reflected state accountability systems, regardless of whether the topic was assessment, curricular pacing, or planning. At times, teachers and administrators made attempts to shift meeting routines from test-based accountability to a focus on instruction and professional accountability; however, existing routines endured. The findings from this study have important implications for thinking through whether and how the field may move towards more intelligent forms of accountability in the presence of external demands and deeply embedded patterns.