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Preschoolers' repeating patterning knowledge is predictive of their concurrent and later math and numeracy knowledge, but strong experimental evidence is needed to determine if these relations are causal. The purpose of the current study was to examine the causal effects of repeating patterning and numeracy tutoring on repeating patterning, numeracy, and general mathematics knowledge in the year before kindergarten (i.e., pre-K). Children in pre-K (N = 211) were randomly assigned to receive five sessions of researcher-delivered tutoring (a) on repeating patterns and numeracy or (b) on numeracy (and literacy as an active control), or received no tutoring and business as usual classroom instruction (control). Children who received tutoring in repeating patterning and numeracy improved in their repeating patterning knowledge the most. However, children's general math and numeracy knowledge improved similarly across conditions, and a specific aspect of numeracy emphasized during the tutoring did not improve. Children's repeating patterning knowledge is malleable, but this initial attempt to demonstrate causal links between repeating patterning and math knowledge was not successful. Results parallel mixed success in research training other skills, such as working memory or spatial skills, for improving mathematics knowledge. Findings are discussed in terms of the relations between patterning, numeracy, and general math knowledge in preschoolers. Educational Impact and Implications Statement: We know that preschool children with better repeating patterning knowledge (i.e., understanding predictable sequences with a part that repeats, like objects arranged ABABAB) also tend to do better on math and numeracy tasks. How can we improve preschool children's patterning knowledge, and does teaching preschoolers patterning along with numbers improve their math knowledge? Our five tutoring sessions improved children's patterning knowledge, but did not improve their math knowledge. The patterning instruction was designed to improve children's knowledge of and ability to duplicate, extend, and abstract (i.e., duplication with different materials) repeating patterns, and identify the unit of repeat in those patterns. Although it was not designed to be used for classroom instruction, key features of our tutoring protocol can be incorporated into preschool teachers' patterning instruction. [ABSTRACT FROM AUTHOR]