In this article, pre-service teachers' mathematics content knowledge is explored through the analysis of two items about ratio from a Mathematical Competency, Skills and Knowledge Test. Pre-service teachers' thinking strategies, common errors and misconceptions in their responses are presented and discussed. Of particular interest was the range and nature of common incorrect responses for one whole-whole ratio question. Results suggested pre-service teachers had difficulty interpreting a worded multi-step, ratio (scale) question, with errors relating to ratio and/or conversion of measurement knowledge. These difficulties reveal underdeveloped knowledge of mathematical structure and mathematical connections as well as an inability to deconstruct key components of a mathematical problem. Most pre-service teachers also lacked knowledge of standard procedures and methods of solutions. (Contains 8 figures and 3 tables.)