The impetus of teacher preparation coursework is to provide pre-service teachers with the skills and experiences necessary to transfer what they learn into practice. Thus, it is imperative to examine the perceived self-efficacy of pre-service teachers' upon completion of coursework. While most pre-service teachers prove confident in their ability to teach core content, their efficacy in teaching content beyond such subjects is nominal at best. As a content area greatly underrepresented within teacher preparation programs, this study examined the perceived self-efficacy of pre-service teachers regarding wellness and physical activity integration. Outcomes were measured through a self-reported survey. Results indicated higher levels of self-efficacy in all categories and statistically significant findings (p = 0.0012) in wellness and physical activity pedagogical content knowledge for students completing at least one wellness and physical activity endorsement course, compared to students who had not completed a course in wellness and physical activity integration.