Algebra test scores of the Maldivian students from grade 6 through 12 are the lowest compared to any other area of mathematics. Algebra is a fundamental topic in mathematics and lays the foundation for mathematical reasoning and complex problem-solving. Research shows that strengthening algebra instruction could improve student achievement. This concurrent mixed methods study examined the algebraic content and pedagogical knowledge of 5 sixth grade mathematics teachers who teach in 5 different schools across the Maldives. Shulman's major categories of teacher knowledge and Ball, Thames, and Phelps' domains of mathematical knowledge for teaching guided this study. The research questions examined the relationship between teachers' perceptions of their mastery of algebraic content and pedagogical knowledge, and what teachers actually know about algebraic content and pedagogy. Purposive sampling was used to select the 5 participants. Quantitative data were collected using the Diagnostic Teacher Assessments of Mathematics and Science - Middle Mathematics Teacher Assessments and qualitative data were gathered through lesson observations, interviews, and analysis of teachers' lesson plans and notes. All participants believed that they were proficient in both algebraic content and pedagogical knowledge. However, the results of this study showed that all participants lacked both algebraic content and pedagogical knowledge. Findings of this study were used to inform and design mathematics professional development to meet the needs of the participants. This mathematics professional development is expected to improve the instructional delivery of algebra through enhanced algebraic content and pedagogical knowledge. This could positively contribute to the improvement of student achievement in algebra.