The purpose of this descriptive study was to investigate elementary music teachers’ perceptions of their preparation to teach elementary general music and implementation of general music approaches. Respondents were Missouri elementary music teachers (N = 142) who were contacted via email. Results indicated that Kodály was the approach implemented by the most participants, followed by Orff Schuwerk, and these two approaches accounted for the greatest percentage of time allocation in the teachers’ classrooms in this sample. The majority of teachers did not have any formal credentials in general music approaches. Out of all the listed aspects of elementary music teaching, responses indicated that teachers felt the most prepared about teaching singing and least prepared to teach improvising and composing with instruments or voice. Teachers who had Orff Schulwerk training felt significantly more confident to teach improvisation and composition than those who had no training in Orff, and teachers who had training in the Kodály approach were significantly more confident to teach listening than those who had no training in Kodály. Open-ended comments indicated that respondents believed their preparation programs focused on secondary music education more than elementary music education. Some respondents continued to develop their expertise in elementary music by attending workshops and professional development events.