Johnson, Cooper, Donald, Taylor, and Millet (2005) surveyed teachers to examine connections between their career and occupational stress and found that teaching was the second most stressful career. In fact, outside of driving an ambulance, teaching was more stressful than 24 other careers. In the age of accountability, stress can be potentially devastating to the educators. Many of the stressful factors that cause a teacher to reexamine his or her career choice come from outside the walls of the classroom. Additionally, a lack of administrative support in schools can lead to a negative climate and cause teachers to seek another career path (Billingsley, 2003). It is these stressful factors that I became interested in. Therefore, the study I conducted provides an outlet for teachers to provide input about the stresses they experience or have experienced during their teaching careers. In offering this data, I wanted to add information to the body of knowledge on teacher efficacy in order to combat teacher stress and/or burnout. While I found a tremendous amount of research on how stress impacts high school teachers (Friedman, 1991) and elementary school teachers (Gold, 1996), I found a lack of data representing middle school teachers. In particular, there is a gap in the available data with respect to rural areas. Therefore, my focus became to investigate rural middle school teachers' perceptions of stress. In researching, I found there is little data available that examines the beliefs and perceptions current middle school teachers hold and how that impacts their teaching practices. My interest became specific to middle school teachers in rural areas. Thus, the purpose of this mixed methods study is two-fold: 1) to learn what factors impact rural middle school teachers' efficacy; and 2) to better understand which of these factors increase their stress (and potential burnout). This study employed to methods of data collection: 1) online survey of 36 teachers; and 2) interviews with 12 participants. This study found that teachers in the rural middle school setting feel they are impacted by more outside stress factors than from within their own classroom. It becomes obvious, though, that the concerns are generated by people and things the teachers have no control over. Micro-politics, trust and support, and the practice of hiring relatives are the main stress factors impacting these teachers. The support and close ties to family, friends and religious associations were places of comfort and solace. The overall implication is that teachers feel more stress based on the type of administrator the school has than on the teaching.