Objectives This study was conducted to find out the effect of integrated children's art classes of exploration, expression, and appreciation on the creativity, art appreciation ability, and art teaching efficacy of pre-service childhood teachers. Methods Participants in the study were 21 students who took children's art courses in the second semester of 2023 among H University students located in D city. This class was held for a total of 45 hours, 3 hours per week. The collected data included pre- and post-survey questionnaires on creativity, art appreciation ability, and art teaching efficacy, art portfolio, and lecture evaluation forms during and at the end of the semester. The results of quantitative analysis (paired samples t test) and qualitative analysis (open coding method) were as follows. Results First, the integrated children's art class of exploration, expression, and appreciation was effective in enhancing creativity, and it was found that it was effective in alternative solutions and original flexibility among sub-areas. Specifically, imagination and creative thinking skills were developed through the exploration of aesthetic elements in life, and my own creative expression ability was developed through cooperative art activities and work appreciation. Second, this class was found to be effective in enhancing the ability of pre-service childhood teachers to appreciate art. Specifically, cognitive appreciation ability was developed through the expansion of art concepts and knowledge, and work appreciation experience centered on aesthetic elements. Third, this class was found to be effective in enhancing the efficacy of art teaching, and in particular, it was found that it was effective in enhancing the individual efficacy of art teaching. Specifically, teaching ability was developed through knowledge and understanding of early childhood art education and experience in art practice, and teaching efficacy was developed through direct and indirect teacher role experience. Conclusions Therefore, it can be seen that it is meaningful to apply an integrated art education class of exploration, expression, and appreciation to the pre-service teacher training course to improve creativity, art appreciation ability, and art teaching efficacy.