This case study examined the implementation of a novel nontraditional teacher preparation program, “Multi-Tiered Systems of Support Preservice Residency Project” (MTSS-PR). The two-year program placed general and special education composite undergraduate majors full time in high-need schools implementing evidence-based systems of behavioral (Positive Behavioral Interventions and Supports) and academic support (Response to Intervention). Project participants received substantial training and practice in Tier 1 core instruction, Tier 2 interventionist activities, and Tier 3 interventions for students with special needs. The effectiveness of the program was evaluated through a district-wide teacher appraisal, measuring teacher-delivered opportunities to respond, ratio of interactions, student engagement, and participant and principal interviews. Results indicated that the MTSS-PR participants not only outperformed other new teachers on the district appraisal, they also outperformed other veteran teachers. At the conclusion of the project, both the participating teachers and their principals scored the project high on a measure of social validity. Methodological limitations exist, however results of the case study have promising implications for teacher preparation that infuses residency-based models within evidence-based practice.