Sentence-based mathematics problem-solving skills are essential as the skills can improve the ability to deal with various mathematical problems in daily life, increase the imagination, develop creativity, and develop an individual’s comprehension skills. However, mastery of these skills among students is still unsatisfactory because students often find it difficult to understand mathematical problems in verse, are weak at planning the correct solution strategy, and often make mistakes in their calculations. This study was conducted to identify the challenges that mathematics teachers face when teaching sentence-based mathematics problem-solving skills and the approaches used to address these challenges. This study was conducted qualitatively in the form of a case study. The data were collected through observations and interviews with two respondents who teach mathematics to year four students in a Chinese national primary school in Kuala Lumpur. This study shows that the teachers have faced three challenges, specifically low mastery skills among the students, insufficient teaching time, and a lack of ICT infrastructure. The teachers addressed these challenges with creativity and enthusiasm to diversify the teaching approaches to face the challenges and develop interest and skills as part of solving sentence-based mathematics problems among year four students. These findings allow mathematics teachers to understand the challenges faced while teaching sentence-based mathematics problem solving in depth as part of delivering quality education for every student. Nevertheless, further studies involving many respondents are needed to understand the problems and challenges of different situations and approaches that can be used when teaching sentence-based mathematics problem-solving skills.