Learning to teach mathematics is a complex endeavor, requiring sustained focus and time. Yet time is especially scarce in elementary teacher education programs, where preservice teachers (PSTs) learn all content areas. Through a collaborative self-study, five teacher educators identified three time-related tensions in elementary mathematics methods courses: (a) teaching mathematics content and pedagogy; (b) connecting theory and practice; and (c) promoting social contexts in teaching mathematics. To address these tensions, we offer three design principles and illustrative examples: (a) addressing multiple goals for each course component; (b) developing PSTs’ dispositions over time; and (c) building on PSTs’ strengths to develop understanding of mathematics. We present a reflection tool to assist mathematics teacher educators in designing their courses to maximize their instructional time.