This study investigated special education teachers' (SETs) work in Finnish lower secondary schools. We wanted to determine what is included in the work and what kind of knowhow is needed to manage it in the contexts of inclusion and the three-tiered support system. Our data consisted of 63 SETs' answers to an e-questionnaire. Using content analysis, we found that work with students remains central, but collaboration with adults has become a big part of the work. The range of different challenges SETs help students with has become wide and duties concerning pedagogical documentation have been added to the work. Regarding work with students, subject content knowledge and knowledge of mental health related issues are accentuated at the secondary stage. Besides professional knowledge base, SETs need self-management skills and a critical but compassionate mindset. Time constraints, coupled with the absence of structures facilitating teacher collaboration, present notable challenges for SET work.