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The experiences of teacher leaders in Mainland China, called Backbone Teachers, were examined to explore Backbone Teachers’ impact from the lens of teacher leadership as explicated in the United States. The 10 participants included 4 Backbone Teachers, 4 non-Backbone Teachers, and 2 principals respectively from 2 middle schools in the same district in Mainland China. Qualitative case study methods were used and included interviews, observations, and shadowing techniques to examine the perspectives of the three groups of school actors—Backbone Teachers, non-Backbone Teachers, and principals. The findings of the study revealed that Backbone Teachers had positive, negative, and other instances of impact on themselves, their peers, their students, and their schools.