One hundred fifty six participants enrolled in a mathematics methods course were involved in the study which specifically examined Mathematics Teacher Efficacy and Mathematics Anxiety in Elementary Pre-service Teachers. Data collection involved findings from the Mathematics Teaching Efficacy Beliefs Instruments (MTEBI), Mathematics Anxiety Rating Scale (MARS), and interviews with pre-service teachers. A significant, negative relationship between mathematics teachers' efficacy and pre-service teachers' mathematics anxiety (r = -0.475, p less than 0.05) was found. Pre-service teacher interviews revealed that efficaciousness towards mathematics teaching practices is associated with mathematics anxiety and is the basis for their mathematics teaching efficacy beliefs. Pre-service teachers with the lowest degree of mathematics anxiety had the highest levels of mathematics teacher efficacy. (Contains 2 tables.)