Lesson study, a teacher-led vehicle for inquiring into teacher practice through creating, enacting, and reflecting on collaboratively designed research lessons, has been shown to improve mathematics teacher practice in the United States, such as improving knowledge about mathematics, changing teacher practice, and developing communities of teachers. Though it has been described as a sustainable form of professional development, little research exists on what might support teachers in continuing to engage in lesson study after a grant ends. This qualitative and multixxi case study investigates the sustainability of lesson study as mathematics teachers engage in a district scale-up lesson study professional experience after participating in a three-year California Mathematics Science Partnership (CaMSP) grant to improve algebraic instruction. To do so, I first provide a description of material (e.g. curricular materials and time), human (attending district trainings and interacting with mathematics coaches), and social (qualities like trust, shared values, common goals, and expectations developed through relationships with others) resources present in the context of two school districts as reported by participants. I then describe practices of lesson study reported to have continued. I also report on teachers' conceptions of what it means to engage in lesson study. I conclude by describing how these results suggest factors that supported and constrained teachers' in continuing lesson study. To accomplish this work, I used qualitative methods of grounded theory informed by a modified sustainability framework on interview, survey, and case study data about teachers, principals, and Teachers on Special Assignment (TOSAs). Four cases were selected to show the varying levels of lesson study practices that continued past the conclusion of the grant. Analyses reveal varying levels of integration, linkage, and synergy among both formally and informally arranged groups of teachers. High levels of integration and linkage among groups of teachers supported them in sustaining lesson study practices. Groups of teachers with low levels of integration but with linked individuals sustained some level of practices, whereas teachers with low levels of integration and linkage constrained them in continuing lesson study at their site. Additionally, teachers' visions of lesson study and its uses shaped the types of xxii activities teachers engaged, with well-developed conceptions of lesson study supporting and limited visions constraining the ability to attract or align resources to continue lesson study practices. Principals' support, teacher autonomy, and cultures of collaboration or isolation were also factors that either supported or constrained teachers' ability to continue lesson study. These analyses provide practical implications on how to support mathematics teachers in continuing lesson study, and theoretical contributions on developing the construct of sustainability within mathematics education research.