This study examined how preservice teachers’ instructional decision making reflected the use of technological, pedagogical, and content knowledge (TPACK) components in an elementary-level special education setting. The findings reveal that the preservice special education teachers had multiple opportunities to practice combining technological knowledge, pedagogical knowledge, and content knowledge to make instructional decisions through technology integration. In addition, the participants blended components of this specialized knowledge to make in-the-moment teaching decisions when integrating technology into tutoring sessions.