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This study investigates the impact of a three-year, state-level mathematics professional development initiative on teachers’ knowledge, teachers’ instructional practices, and student achievement. The purposes of sharing these results with the research community goes beyond determining the effectiveness of the initiative itself. The research identifies the professional learning activities that occurred, the subsequent changes observed in teachers’ math knowledge and instructional practices, and contributes to the discussion of multiple sources of evidence in examining teacher-accountability. Results indicate that: 1) teachers’ content knowledge increased significantly each year 2) most teachers were observed using cognitively challenging tasks, but less than half engaged their students in mathematical discussion, and 3) teachers with higher mathematics knowledge tended to use more ambitious instructional practices.