This case study explores the professional identity of one reading specialist, Marsha, who struggled with testing pressures at her urban elementary school in the U.S. It offers an in-depth look at how Marsha's instructional decisions and practices in a pull-out reading program aimed at helping English Language Learners (ELL) shifted when she was faced with tensions between her own professional beliefs and knowledge about effective reading instruction and district based pressures to help her students pass the "test." Unlike other studies, instead of viewing teachers as autonomous agents who make simplistic instructional decisions in response to testing pressures, this article illuminates the complexities and contextual tensions some reading teachers must navigate in an era of high stakes accountability. Ethnographic and grounded theory methodologies were used for this study. Findings suggest that Marsha struggled over her commitment to help her students pass the test and at the same time grappled with how to stay true to her own professional identity. This tension pushed Marsha to change her literacy practices gleaned from years of experience for a test focused literacy curriculum. Implications from this study suggest that testing pressures not only affect teachers' instruction and responsiveness to students' learning needs but can compromise a teacher's professional identity and can influence teachers' responsibility and ethical sense of what they should do for their students and who they need to be as teachers.