This article reports on teachers' knowledge and perceptions and the issues they are concerned about in relation to pronunciation teaching. Understanding teacher cognition helps to ensure research and pedagogical advice are appropriately directed. However, there has been only a limited amount of research in this area. The researcher collected data for this study through semistructured interviews with 19 English language teachers in New Zealand. A number of themes emerged, including a lack of initial training and knowledge of phonology, leading to uncertainty about exactly what should be taught and how. This often meant pronunciation was neglected, especially in areas such as stress and intonation. It was also found that much teaching was ad hoc and in response to errors. Concerns included how to teach pronunciation in mixed-first language classes and how to help learners with speech perception. The findings raise questions for reflective practice, teacher education, and professional development; recent research has found some answers, but these are not all represented in the knowledge base of teachers, teacher education courses, or classroom textbooks. The issues raised also underline the need for more research in a number of areas.