In this qualitative study, I examined teachers' perceptions of the influence of high stakes testing on instructional practices and student learning and engagement in middle schools in rural Southwest Virginia. Fourteen middle school teachers from three middle schools completed questionnaires, and seven teachers submitted lesson plans as part of this study. I analyzed the data and determined teachers expressed negative perceptions of the effects of high stakes testing on student learning and engagement. Teachers also stated high stakes testing limited instructional practices used in classrooms. Teachers perceived current instructional practices were not conducive for active student learning and engagement; however, these teachers felt restricted by the state-prescribed curricula and high expectations for student performance on high stakes testing. [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.]