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To better support the education of multilingual learners with disabilities, TESOL teacher education programs should enhance teachers’ self-efficacy beliefs and educational practices regarding not only language, but also academic instruction that meets the needs of this population of students. This mixed-methods study examined 46 in-service teachers’ self-efficacy beliefs and practices related to the education of multilingual learners with disabilities after participating in a TESOL graduate program. Findings of this research showed significant increases in teachers’ self-efficacy across multiple teaching competencies. Greatest gains emerged in domains primarily focusing on learner needs. Our findings highlight the need for more comprehensive approaches to preparing teachers serving MLDs.