One factor that can influence identification of students with disabilities is teachers’ decisions to refer a student for special education services. Both teacher and student characteristics can influence teachers’ decision making. As evidenced in research and theory, teacher characteristics of efficacy influences teachers’ classroom practices, student outcome, and teachers’ perceptions about working with students with disabilities, which might also influence teachers’ decisions to refer students for special education evaluation. As a primary purpose, I examined whether elementary education teachers’ sense of efficacy predicts their decisions to refer a student for special education evaluation and their decisions to place a student in a special education classroom in Turkey. As a secondary purpose, I examined teacher demographic characteristics (i.e. teachers’ educational degree, teachers’ gender, years of teaching experience, and in-service training), student characteristics (i.e. students’ gender and problem type), and teachers’ decisions in regard to referral and placement. This study included data analysis from 264 elementary school teachers with a response rate of 85.2% from one town of a metropolitan city in the East Marmara region of Turkey. I used the Teachers’ Sense of Efficacy Scale (Tschannen-Moran & Woolfolk Hoy, 2001) to examine teachers’ sense of efficacy. I also developed the Teachers’ Decisions in Regard to Referral Measure (TDRRM) to examine teachers’ decisions in regard to referral and placement. Results indicated: (a) there was evidence that some factors of teacher efficacy and some demographic characteristics predicted respondents’ decisions, (b) there was a difference in the ways teachers responded to the cases based on the problem type. Limitations and implications for future research were discussed.