Background/purpose: The purpose of this qualitative study was to identify strengths and deficits of alternative teacher certification programs, with particular emphasis on approaches to strengthening mathematical content knowledge and pedagogy. Materials/methods: Six participants included both teacher candidates enrolled in internship in the alternative master's elementary or early childhood program and recent graduates of the programs at a university in the southeast United States. Data were collected through semi-structured interviews conducted via an online focus group to elicit conversation among the participants of their combined perceptions of program-level recommendations to better prepare them to teach elementary mathematics. Using inductive, open coding of the transcribed data, the researchers identified and ultimately agreed upon the emerging themes related to perceptions of preparation program components. Results: Related to research question one, participants shared meaningful experiences related to the instructor modeling effective mathematics teaching practices that have impacted their own teaching. Related to research question two, five common themes, including recommendations for improvement, were revealed: Need for more preservice mathematics methods instruction and theory into practice; Preparedness for accommodating diverse needs; Analyzing student data to inform practice; Utilizing and securing available resources; and navigating curricular changes/district mandates. Conclusion: Based on the results of the study, teacher candidates in the elementary and early childhood alternative master's programs are in need additional content, pedagogy, and resources to effectively teach elementary mathematics.