South Africa's policy on screening, identification, assessment and support (SIAS) stipulates that teachers support learners with barriers to learning and development in their mainstream classrooms. This includes learners living with Attention-deficit/hyperactivity disorder (ADHD). Yet, little research has been conducted regarding Grade 1 teachers' utilisation of support strategies for learners living with ADHD in mainstream classrooms. This study focused on Grade 1 teachers' support for learners living with ADHD. An exploratory, interpretive, interactive, qualitative case study was employed. Twelve purposefully selected Grade 1 teachers, representing five public schools (varying from Quintile 1-5) and one private school from the West Coast Education District, South Africa, participated in an unstructured open-ended focus group interview resulting in an interview framework being developed. This interview framework directed the field observations of classroom visits and semi-structured individual interview questions of six purposefully selected Grade 1 teachers. Qualitative content analysis was used to analyse the transcriptions of the individual interviews, as well as the field notes. The study found that teachers were innovative in developing effective support strategies to support Grade 1 learners living with ADHD in their classrooms.