In the past, visual arts education in Hong Kong was not considered an important area of early childhood education. While the Hong Kong kindergarten curriculum has recently been updated to encourage creativity, there remains a lack of adequate visual arts education for young children. This deficiency stems from the fact that the visual arts receive minimal attention within Hong Kong teacher education programs. Little research has been conducted on how visual arts education is actually delivered in local kindergarten classrooms in Hong Kong and what kinds of artistic knowledge and skills kindergarten teachers need. Therefore, this study aimed to investigate kindergarten teachers’ content knowledge and pedagogical content knowledge in early visual arts education (EVAE) and to identify the challenges they faced in teaching visual arts to children. The study surveyed 342 in-service kindergarten teachers in Hong Kong and conducted individual interviews with 12 participants. The findings revealed that Hong Kong kindergarten teachers generally performed well in terms of their pedagogical content knowledge, but they lacked content knowledge in various forms of early visual arts (EVA) and faced challenges in teaching visual arts effectively. This study has the potential to change how early childhood visual arts teaching is conceptualized and taught in Hong Kong and other Asian regions.