Mathematical achievement is an early predictor of students' academic outcomes, and mathematics achievement continues to be important throughout life. Thus, it is essential to examine instructional methods that enhance mathematical learning. One method that may impact mathematical learning is the use of gestures, yet a comprehensive methodical review of the data has not been conducted. The current study examined the impact that gestures have on student learning when educators use gestures during mathematical instruction and educators' perception of student mathematical knowledge when students use gestures. A systematic search was conducted to assemble research studies that evaluated the use of gestures in mathematical instruction with students in preschool to 12th grade. Empirical data from 35 research articles indicate that gestures used by students or educators that enhance verbal instruction can increase student mathematical performance and memory. Furthermore, it is practical to teach students and educators to use gestures effectively during mathematical learning. [This paper was published in "Gesture" v17 n3 p375-416 2018.]