Integer arithmetic is difficult for students worldwide. Although students' integer thinking has frequently been studied, little is known about typical instructional practice for this difficult topic. Thus, to investigate what resources teachers use, we surveyed U.S. middle-grade teachers who teach negative numbers. About half the teachers said they need more integer resources and about two-thirds of the teachers used Teachers Pay Teachers to obtain such resources. During an integer unit, each classroom used up to 7 contexts and tools/models. Moreover, we analyzed which features of tools teachers reported using. Horizontal number lines were used significantly more often than vertical. The physical tools used for chip models reflected commercially-determined valence associations that were inconsistent with real-life symbolizations, significantly more than conceptually consistent symbolizations. Therefore, recommendations include the following: (a) encourage teachers and researchers to focus on how features of tools (number line directions, chip colors and symbols) affect students' experiences and learning (b) evaluate potentially optimal sequences of models and contexts, (c) make quality integer resources freely accessible to U.S. teachers in the spaces they look to reduce for-profit influences and (d) provide criteria to support teachers to select resources based on learning affordances irrespective of commercial availability.