Research suggests the importance of mathematics knowledge for teaching (MKT) for enabling elementary school teachers to effectively teach mathematics. MKT involves both mathematical content knowledge (M-CK) and mathematical pedagogical content knowledge (M-PCK). However, there is no consensus on how best to prepare elementary preservice teachers (PSTs) to achieve M-CK and M-PCK. This study builds on research related to MKT by investigating influences of mathematics content courses designed specifically for elementary PSTs (IMPACT courses--Impact of Mathematics Pedagogy and Content on Teaching) on their attitudes (i.e., confidence and motivation) toward M-CK and M-PCK. Results suggest that the PSTs who participated in these IMPACT courses not only acquired high levels of confidence and motivation toward M-CK, but also showed significant and greater gains in attitudes toward M-PCK, after taking the required mathematics methods course, than their counterparts. Further, the findings suggest that these IMPACT courses provided a mathematical foundation that allowed the PSTs to engage in mathematics teaching methods better than those PSTs who did not have such a foundation. These results suggest potential course experiences that may enhance M-CK and M-PCK for elementary PSTs.