The use of program quality indicators (QIs) for teaching students with an intellectual disability (ID) is essential in meeting student needs and accessing curriculum. Principals who oversee and evaluate teachers of students with ID play a critical role in the implementation of QIs. A cross-sectional survey was conducted to investigate rural school district principals' perceptions of the importance, teacher implementation, and principal ability to provide feedback on QIs for students with ID. Results indicate differences between principal perception of importance of indicators and reported confidence in ability to provide feedback on indicators. More specialized QIs received lower ratings of perception of importance and lower ratings in perceptions of confidence to provide feedback. Differences existed between principal perception of importance of QIs and reported observance of teacher implementation. Several QIs were reported as important, as implemented, and that principals are confident in giving feedback.