This study validated measures for elementary preservice teachers' technological, pedagogical, and content knowledge (TPACK) for elementary mathematics and evaluated the extent to which technology knowledge, pedagogy knowledge, and content knowledge were related to the formation of TPACK. The study was guided by the TPACK framework and adopted a widely used survey instrument. Participants were elementary preservice teachers at the end of a mathematics method class at a midwestern US teacher preparation program. The study used confirmatory factor analysis and structural equation modeling to analyze measurement and predictive models. The confirmatory factor analysis validated a four-factor correlated measure of technological knowledge, pedagogical knowledge, content knowledge, and TPACK. The structural equation model indicated technological knowledge and pedagogical knowledge significantly predicted TPACK in elementary mathematics, but content knowledge did not. Preservice elementary school teachers indicated that their technological expertise was lower than their pedagogical knowledge, content knowledge, and TPACK. The results underscore the importance of strengthening TPACK in elementary teacher preparation programs with a focus on mathematics, enhancing the proficiency of preservice teachers in utilizing technology for effective mathematics teaching. This is particularly critical due to rapid technological change and shifts in students' needs and competencies.