Education policies in the United States and other nations have established academic standards and made teachers accountable for improved standardized test scores. Because policies can have unintended effects, in this study we investigated U.S. elementary school teachers’ perceptions of their state’s accountability policy, particularly its effect on their job engagement. We found support for a path model relating lack of policy support to teacher burnout via two mediators: role conflict and reduced self-efficacy. Results of interviews with a subset of teachers were consistent with the model. We conclude with recommendations to reduce teacher stress in manners consistent with the goals of accountability policies.