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Despite trends towards STEM education within North America, teachers often report feeling unprepared to teach in integrated ways, with assessment identified as a central barrier. The purpose of this study was to empirically investigate the conditions that enabled exemplary elementary teachers to use assessment to support integrated STEM teaching and learning. Through an in-depth qualitative methodology and drawing on interview and artefact data from 12 purposefully selected elementary teachers, this study identified four key themes: (a) leveraging the complex intersection of skills and knowledge; (b) the power of teacher collaboration; (c) the importance of formative assessment within socio-cultural design tasks; and (d) alternative spaces for learning. Results demonstrate assessment can be purposefully used to support integrate STEM education.