In 2010–2011 Frederick Leung together with the group of authors conducted an international comparative study on pre-service mathematics teachers’ knowledge in the area of elementary mathematics from a higher standpoint according to the ideas of Felix Klein. More than 10 years later the study was replicated as a national study in Germany in an extended version, now also including pre-service teachers’ beliefs on the relation between school and university mathematics. In this chapter, the study and central results are presented, showing amongst others that for the German sample the respective knowledge remained relatively stable and that the pre-service mathematics teachers slightly consent to the coherence between school and university mathematics but evaluate university mathematics as less relevant for their later work in school.