The reflections and knowledge development of 7 preservice teachers during a field-based elementary methods course were analyzed and described. Data sources included audiotapes of weekly one-hour reflection sessions, nonparticipant observation of methods course meetings and field experiences, three interviews, and documents. Data were analyzed using a constant comparison method. Changes in the preservice teachers’ knowledge were conceptualized in terms of advanced knowledge acquisition (i.e., relations within their knowledge structures). The preservice teachers (a) made managerial decisions in relation to their effect on the learning environment, (b) planned lesson content in relation to past and future lessons, (c) considered the children’s prior learning and skillfulness in relation to subject matter decisions, and (d) connected their choice of words and actions to the children’s perspectives. The preservice teachers did not, however, develop the ability to respond pedagogically to students during an actual lesson. Linkages between the reflection process and the preservice teachers’ development are drawn.