This qualitative study examined Response to Intervention (RtI) in a rural preschool program. The researcher sought to understand the implementation of RtI and how it actually looked in an in vivo setting. Purposeful sampling was used to select the preschool site, and criterion sampling was used to select participants for interviews. Two focus group sessions were digitally recorded, transcribed, and analyzed. Ten preschool staff members including seven regular education pre kindergarten teachers, one speech language pathologist, and two special education teachers were interviewed. In addition, eight parents were interviewed individually. Interviews were tape recorded using a Sony ICD BX 700 digital recorder, and results were transcribed. Other data sources included continuous field notes and memos maintained by the researcher classroom observations of interventions, lesson plans maintained by teachers, anecdotal records, RtI referral forms, and other documents. Data was organized into coded sections and using the NVivo 8 data analysis computer software, themes were identified. Categories and themes were analyzed using the grounded theory approach as the dominant method of analysis via categorical aggregation. Data analysis through categorical aggregation indicated that the following factors appeared to positively impact RtI implementation in preschool: knowing childrens backgrounds, frequent contact with parents, and getting help from special education personnel. Factors negatively impacting the process included the following: increasing demands on teacher time, managing red tape and legal issues, lack of clear guidance with too much ambiguity, and concerns about accountability. RtI resulted in fewer referrals to special education, but the long term ramifications are not known.