The current study investigated the effects of an undergraduate mathematics content course for pre-service elementary teachers. The participants' content knowledge was quantitatively measured using an instrument comprised of items from the Mathematical Knowledge for Teaching Measures (Hill, Schilling, & Ball, 2004). Using a one-group pretest-posttest design, matched pairs t-tests showed significant gains (p = 0.000) in both common and specialized content knowledge and in two areas of prerequisite algebra concepts (numbers and equations/functions). Results provide evidence of pre-service teachers developing mathematical understanding beyond common content knowledge within collegiate course settings. (Contains 1 table.)