The number of elementary STEM schools has increased in the years following the 2010 President's Council of Advisors in Science and Technology's call for the expansion of STEM schools at the elementary level. With scant research beyond their initial year of operation, this qualitative study sought to gain insight into the perceptions and concerns teachers and administrators had in four STEM elementary schools regarding their enactment, and recommendations for the schools' sustainability. Focus groups and interviews conducted asked participants to rate and discuss their school's alignment with components found to be critical to effective STEM elementary schools (House et al., 2020). This provided a dimension of clarity and depth as participants shared concerns they had regarding the enactment of their schools, and recommendations for their sustainability. The conducting of a document review provided insight into the original vision and guiding principles developed in the planning for these schools. Triangulation was achieved through multiple data sources. The social constructivist theory provided a lens through which to apply components of Fullan's theory of educational change and Hall and Hord's (2020) Concerns Based Adoption Model. Results were analyzed through a combination of provisional and open coding. Findings revealed the need for the development of an operational definition for what it means to be a STEM elementary school, the need for a district commitment to STEM in the elementary schools to support their sustainability, and the need for high quality, integrated STEM curricula. This study examines the enactment of STEM elementary schools beyond the first five years of opening, it identifies concerns of teachers and administrators in these schools regarding their implementation, and it provides recommendations for sustainability from those most closely aligned with their success. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]