Since William Alexander's (1963, 1995) call for attention to the need for specialized middle level teacher preparation in 1963, 45 states have created requirements for middle level certification, licensure, or endorsement (Association for Middle Level Education [AMLE], 2014) which have led to institutions of teacher preparation creating routes designed to prepare candidates to teach grades 5--9. Because of questions raised about content and consistency of these programs, this study systematically documents components of undergraduate middle level teacher preparation programs in 1,324 institutions from 50 states and the District of Columbia. The findings reveal that even though 45 states have explicit mandates for middle level certification, licensure or endorsement, almost half of the institutions preparing teachers for grades 5-9 do not offer courses or experiences specific to middle level education or young adolescents.