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This study aims to understand the relationship between the quality of implementation of a literacy-focused Multi-Tiered System of Support (MTSS) and teachers’ confidence around teaching literacy. The study is part of a larger evaluation that is looking at the implementation and outcomes of a statewide initiative. More specifically, we draw on the statewide implementation of a literacy-focused MTSS as a context for exploring teachers’ confidence with supporting literacy learning. We offer evidence that supports the idea that high-quality implementation of MTSS is related to higher levels of teacher confidence around foundational literacy skills. We also discuss areas of literacy instruction where this relationship is not clear and offer ideas for future research.