A No Child Left Behind Act of 2001 Title II audit found the state of North Carolina out of compliance with the definition of teacher quality for secondary special education teachers. The state specific Praxis exam and the Highly Objective, Uniform State Standard of Evaluation these teachers completed to earn certification to teach subject area content to students with disabilities were found invalid. The purpose of this descriptive, case study was to explore teacher quality in special education for alternatively certified secondary special education teachers who directly instruct students with disabilities in core content areas, in a single school district in central North Carolina. This research used data from interviews, an essay, document review, and data journal. The criterion-based sample consisted of four participants representing middle and high school special education teachers. This study followed a method of within-case and cross-case analysis of data Miles and Huberman (1994) developed with the use of displays, to show the categories of descriptions obtained from the participants. The most significant finding in this study revealed that after the NCLB Title II audit in the 2009-2010 school year in North Carolina, all of the participants considered themselves highly qualified to teach students with disabilities in the content areas because of their years of experience, contradicting the audit findings. There are recommendations for (a) state education agencies, (b) institutions for higher education, (c) local education agencies, and (d) alternatively certified special education teachers. The most prominent recommendation is that policymakers at the state level should work towards establishing a uniform set of requirements for secondary special education teachers that directly reflect their background and teaching experience within and across states.