Significance. The elementary educator is the primary health educator for elementary level school health instruction in the state of Georgia. Therefore, it is incumbent upon the classroom teacher to deliver health instruction and assess students' knowledge, attitudes, and skills. A review of literature found scant attention to the K-5 instructional practices and staff development needs for health instruction. The purpose of this study was to assess elementary school health instruction by measuring professional practices and development opportunities of elementary teachers across the state of Georgia. Design. The survey, adapted from the 2000 School Health Education Profile Lead Health Education Teacher Questionnaire, was developed to measure health instruction practices across 22 health topics and selected staff development needs. A panel of experts reviewed the adapted survey for content validity and clarity of wording and instructions. The survey was piloted with seven elementary educators from a local school district. A database of all schools having elementary grades P-5 was comprised from the 2000 Georgia Public Education Directory (N=1035). A random selection of schools (n=250) was generated from this list. Surveys were sent to principals who then solicited teacher participation. Descriptives statistics were used to portray the data regarding health instruction practices and professional development activities. Results. A total of 167 teachers participated in the survey yielding a 67% response rate. Of the 22 health topics, alcohol or other drug use prevention, tobacco use prevention, nutrition and dietary behavior, physical activity and fitness, violence prevention, and personal hygiene ranked the highest as topics taught by the teachers. Pregnancy prevention, suicide prevention, STD prevention, death and dying, CPR and HIV prevention were reported at being taught the least. Of the nine health skills, resisting peer pressure, conflict resolution, and decision-making ranked the highest as being taught. Analysis of media messages, accessing valid health information, and advocating for personal, family, and community health were the least taught. Considering method of instruction used by the teacher, group discussion, cooperative group activities, and role-play rated highest, while computer assisted instruction, the Internet, and peer educators were least reported as being used. Considering staff development, violence prevention ranked highest in both in-service received in the last two years and most desired topic for future in-service. Teachers appear to be teaching those topics that align with the six CDC risk behaviors except sexual behaviors that result in HIV, STD or unintended pregnancy.Keyword(s): elementary education, professional development