One enduring problem in the field of mathematics education is preparing teachers to present mathematics in sufficiently deep and meaningful ways to their students. A focus of this preparation is developing in practitioners sufficient knowledge of mathematics for teaching. Mathematical knowledge for teaching has been theorized widely and is currently the focus of many empirical investigations in the field. This study positions itself within this literature and seeks to connect the research to undergraduate, pre-service elementary school teachers (PSTs), and the content courses which comprise the bulk of their mathematical preparation within a typical university teacher education program. Little is known about the impact that these courses have on teacher knowledge and still less has been studied about the efficacy of different pedagogical--or mathematical--approaches in these courses among PSTs. In order to test claims made in situated learning theory and respond to prevalent political rhetoric about mathematics teacher education, this project compared mathematics courses designed for PSTs in two different universities along three dimensions: (1) Differences in pedagogical and mathematical approaches to developing content knowledge for teaching in PSTs; (2) Resulting differences in PST performance on mathematical knowledge for teaching instruments (3) Resulting differences among PSTs' attitudes about mathematics, teaching, and their perception of the course's relevance to their anticipated work as elementary school teachers. Data from multiple data sources reveals that, though differences were small, PSTs' mathematical knowledge for teaching was substantively different between the two campuses. In addition, the data indicate that PSTs developed different attitudes about mathematics and teaching. Finally, PSTs' evaluated their course's relevance for teaching practice differently. This study suggests that when designing content courses for pre-service teachers, teacher educators should pay close attention to the interaction between mathematical approaches and pedagogical perspectives.