This qualitative case study investigates how a Technological Pedagogical Content Knowledge (TPACK) course impacts the development of preservice English teachers’ TPACK, as well as their perceptions and attitudes towards technology integration in English Language Teaching (ELT). While much of the existing research on TPACK development in preservice teacher education focuses on generic technology courses, this study addresses the gap by exploring how content-specific courses can enhance TPACK in preservice teachers. To achieve this, the course was designed using TPACK Design-Based Learning (TPACKDBL) principles (Baran & Uygun, 2016), aimed specifically at exploring the TPACK development and experiences of preservice English teachers. Despite numerous studies examining TPACK in preservice education, concrete evidence of TPACK development within content-specific contexts remains scarce. Therefore, this study collected and analysed self-report data (semi-structured interviews, peer feedback, reflective journals, and macroteaching application reports), observations (microteaching), and performance assessments (design activities) to explore the development of TPACK and perceptions of technology in a course offered at a higher education institution in Israel. The data analysis resulted in five key themes: Design Activities, Experiences in Technology-Enhanced Teaching, Integrating Technology to Support Pedagogical Practices in English Language Instruction, Perceptions and Attitudes Towards Integration of Technology into Teaching, and Perceived Value of the Course. The findings demonstrate that the preservice teachers developed TPACK by making connections between technology, content, and pedagogy. In addition, the study provides insights into preservice teachers’ perceptions and attitudes towards technology integration in ELT and the TPACK-based course. This study contributes to enhancing teaching practices and informs the design of technology courses in preservice teacher education, recommending that such courses be tailored to subject-specific content using TPACK-DBL principles to develop preservice teachers’ skills in the design and implementation of technology.