This study examines how preservice elementary mathematics teachers create patterns, write pattern problems, and prepare and apply lesson plans on this topic. In this context, five preservice elementary mathematics teachers who were in the final semester of their undergraduate education volunteered to participate in this research. The study was carried out within the scope of an elective course which lasted eleven weeks and in which patterns were discussed. Data were collected through interview, observation and document analysis. The results show that besides the complexity and originality criteria of written problems, preservice teachers have difficulty in writing quadratic growing pattern problems. In addition, some preservice teachers adopt a teacher-centered approach in planning and implementing their lesson plans. Most of the preservice teachers did not make connections between patterns and daily life and most of them did not use concrete materials in their lesson plans or lessons.