Presession pairing is an antecedent intervention that has shown to decrease problem behavior of elementary school children with autism, whose problem behavior is maintained by social reinforcement. It has also shown modest increases in academic responding. However, the research on presession pairing has not examined its efficacy or acceptability in the natural classroom setting when implemented by the teacher. Therefore, this study used teacher training and a multiple baseline across participants design to test the potential efficacy of teacher-implemented presession pairing in increasing on-task behavior and reducing problem behavior of four students with problem behavior in inclusive public elementary school classrooms. The results indicated that the presession pairing successfully increased on-task behavior and decreased problem behavior for all participating students. The social validity assessment indicated that the teachers found the presession intervention contextually fit, easy to implement, and effective for all students in the classroom.