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This study examines the impact of the Primarily Math Elementary Mathematics Specialist program on K-3 teachers' mathematical content knowledge for teaching, attitudes toward learning mathematics, and beliefs about mathematics teaching and learning. Three cohorts of teachers participating in the program were compared to a similar group of non-participating teachers. Teacher outcomes were measured longitudinally across 5 years. Participating teachers showed changes in their knowledge, attitudes, and beliefs in line with program goals immediately after completion of coursework. Moreover, these changes were sustained in subsequent years, following program completion. Relative to the comparison group, participants demonstrated greater gains in knowledge as well as greater improvements in attitudes and beliefs. Implications of these results for professional development design, implementation, and evaluation are discussed.