This article presents an integrated systematic review of scholarship related to preparing preservice teachers (PSTs) to teach multilingual learners in U.S. schools. We drew from cultural-historical activity theory to investigate how teacher educators who focus on preparing PSTs to work with multilingual students attended to the linguistically responsive teaching (LRT) framework. We identified three distinct activity systems, each linked to specific LRT dimensions. The ways in which the components of each activity system integrated LRT have implications for both theory and practice. Specifically, our findings highlight the need for program-wide coherence in teacher preparation and for comparative analysis examining teacher education across diverse policy contexts.