The role of school leaders today directly impacts students and staff. Research into educational leaders’ perspectives and experiences with Multi-Tiered Systems of Support (MTSS) provides a lens to help examine the culture of training and constructs of knowledge, of school leaders. The five research questions that drove this research study were: (1) What are school leaders in rural counties in Western Massachusetts current knowledge of MTSS implementation? (2) What experience do these school leaders have with implementing MTSS? (3) What training on MTSS did these school leaders receive? (4) Do these school leaders feel prepared to implement MTSS? (5) What additional knowledge, training and supports do these school leaders believe they would need to effectively implement MTSS? To answer the research questions, the study employed a mixed-methods sequential explanatory (MMSE) research design. Findings show that leaders have heard of MTSS and have a general understanding of what MTSS is. Leaders want to be trained in MTSS implementation. Since, the state offers no formal training in MTSS for leaders, leaders’ knowledge of MTSS implementation is limited at this time. However, despite leaders lack of training, leaders feel prepared to implement MTSS. Leaders are educating themselves about MTSS and using parts of it in their schools. Ultimately, the majority of leaders are able to implement parts of MTSS but not the system of MTSS, which creates confusion about what MTSS really is. Leaders knowledge and experience with MTSS expands the research on educational leaders’ knowledge and training as a whole. It is important that school leaders receive high quality education and training that helps them stay current in the field. Leaders should have a voice in the training they need. Districts and states need more sustainable training systems for leaders in MTSS, and some means of measuring leaders’ knowledge, so leaders are given the supports and training they need. It is imperative that leaders receive high quality education and training to improve the outcomes of all staff and students.