Introduction: The amount of teacher preparation has been shown to significantly influence teachers' self-efficacy and their effectiveness in delivering high quality health education lessons that result in student behavior change. Purpose: The purpose of this study was to examine the relationship between teacher preparation and health teaching self-efficacy in pre-service elementary and secondary teachers. Methods: The study was approved by the Human Investigation Committee at the University where it was conducted. The study sample consisted of graduating students (n = 1770) at a large Midwestern urban university. The sample was 54% female, 46% male, 61% Caucasian, 24% African American and 15% other. A 46-item survey instrument was designed to determine self-efficacy expectancy, (the person's belief about his or her capability to perform a certain behavior), outcome expectancy (that the behavior will or will not lead to a desired outcome) and outcome value (that the outcome is meaningful). Demographic questions addressed the number of health courses taken, number of methods courses taken, hours completed in a school intern experience, hours completed of student teaching, grade point average and score on the state certification exam. Construct validity, internal reliability and test-retest reliability were all established on the instrument. Two separate Stepwise Multiple Regression Analyses were conducted with the self-efficacy expectancy or outcome expectancy scores entered as the dependent variable and all of the other variables entered as independent variables. Predictors that contributed no unique variance to the model were excluded. Analysis/Results: For self-efficacy expectancy, only three variables made a significant contribution to the variance: hours completed in a school intern experience r2 = .26, p = 0.001; number of methods courses taken r2 = .17, p = 0.002; and hours completed of student teaching r2 = .30, p = 0.000. These three variables combined to account for 67% of the variance in teaching self-efficacy in pre-service teachers. For outcome expectancy, only two variables made a significant contribution to the variance: hours completed in a school intern experience r2 = .57, p < 0.001; and hours completed of student teaching r2 = .45, p < 0.000; accounting for 62% of the variance. Conclusions: This research indicates that self-efficacy is directly linked to health teaching methods classes as well as the amount of time that pre-service teachers spend in actual public school classrooms. Therefore, universities that provide teacher training should place additional emphasis on these two areas in the training of pre-service teachers. Keyword(s): health education college/univ, pre-service/student, professional preparation