Ten years since the initial commitment to universal primary education, a recent midterm report (MDG: 2010) shows that considerable strides have been achieved towards the goal and that more and more children are accessing primary education. Key initiatives such as the abolition of school fees at primary school level have led to a surge in enrolment in a number of sub-Saharan African countries. In the Republic of Tanzania, the enrolment ratio jumped to 99.6 per cent by 2008 (MDG report: 2010), as the country makes considerable efforts to provide access to more and more children in primary school. Although this progress is laudable and a success story at one level, there are a number of consequences and short-comings such as the shortage of trained teachers, the lack of primary schools to cater to the demand, the lack of resources, the shortage of teaching materials, and over-crowded classrooms. It appears that quantity not quality has taken over (Sifona, 2007). What the quantitative data do not show is what is actually happening in reality on the ground. This chapter describes an intensive two-year case study that was conducted in a primary school in Dar es Salaam, Tanzania from February 2009-2011. The aim of the study was to engage in a research and development initiative with a ‘typical’ urban primary school and to gather detailed evidence of how the school was functioning and coping with the challenges exacerbated by the impact of MDG targets. In particular, the research looked at pedagogical practices and the role of leadership from a whole school perspective. It explored context-specific challenges and discussed culturally relevant approaches of how pedagogy could be improved through the perspectives and actions of local teachers in a sustainable and cost-effective way.