Purpose: This review contrasts the U.S. and Chinese mainland in terms of educational technology programs' effects on mathematics achievement. The existing evaluation studies are assessed and compared, especially from the perspective of research quality. Moreover, this review finds out what intervention programs work in these two countries and classifies evidence levels of effective programs. Design/Approach/Methods: A systematic review and meta-analysis method is used. Findings: The application of educational technology programs produced a better effect in Chinese mainland than in the U.S., however, the quantity and quality of evaluation studies is concerning in Chinese mainland. Since 2010, four programs in the U.S. and one program in Chinese mainland have qualified for strong evidence of effectiveness, which are worthy of receiving scale-up grants. Originality/Value: This is the first systematic review to contrast the U.S. and China in terms of educational technology programs' effects on mathematics achievement. Determining what works through high-quality experiments is probably the most important requirement for evidence-based reform in education. This review compares the developments of the U.S., a leader of the movement, with those of China, an undecided observer. The review may provide enlightenment for the undecided countries and regions.