This study investigates pedagogical content knowledge (PCK) among teachers teaching mathematics at the preschool level in Colombia, highlighting the importance of integrating mathematical knowledge with innovative and effective pedagogical strategies. Using a mixed exploratory and transactional methodology, the perceptions and practices of 82 teachers were examined, focusing on their understanding of mathematical content, pedagogical skills, and knowledge of children’s cognitive development. The findings reveal a significant gap in teachers’ understanding of these concepts, indicating a critical need to strengthen PCK among teachers. To this end, training should be provided to enable teachers to foster meaningful and contextualized mathematical learning in preschool students. The study suggests reviewing teacher training curricula and fostering the development of pedagogical strategies that prioritize conceptual understanding and mathematical reasoning. Additionally, it identifies critical areas for improvement and offers concrete recommendations for transforming mathematics teaching in preschool education. To enhance the quality of mathematics education, several measures are proposed: ensuring continued availability of training programs for teachers, encouraging collaboration between educators, adopting constructivist approaches, and helping teachers understand the value of mathematics learning outside the school.