This study investigated middle school students' conceptual understanding of algebraic equations. 257 sixth- and seventh-grade students solved algebraic equations and generated story problems to correspond with given equations. Aspects of the equations' structures, including number of operations and position of the unknown, influenced students' performance on both tasks. On the story-writing task, students' performance on two-operator equations was poorer than would be expected on the basis of their performance on one-operator equations. Students made a wide variety of errors on the story-writing task, including (1) generating story contexts that reflect operations different from the operations in the given equations, (2) failing to provide a story context for some element of the given equations, (3) failing to include mathematical content from the given equations in their stories, and (4) including mathematical content in their stories that was not present in the given equations. The nature of students' story-writing errors suggests two main gaps in students' conceptual understanding. First, students lacked a robust understanding of the connection between the operation of multiplication and its symbolic representation. Second, students demonstrated difficulty combining multiple mathematical operations into coherent stories. The findings highlight the importance of fostering connections between symbols and their referents.